The Dutch CISOE-A framework for cytology reporting increases efficacy of screening upon standardisation since 1996
The Dutch CISOE-A framework for cytology reporting increases efficacy of screening upon standardisation since 1996
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DOI：
10.1136/jcp.2003.011841
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发表时间：
2004-04-01
影响因子：
3.4
通讯作者：
Meijer, CJLM
中科院分区：
文献类型：
--
作者：
Bulk, S;van Kemenade, FJ;Meijer, CJLM
目的：描述引入cisoa框架报告宫颈细胞学结果的影响，包括荷兰重复和转诊建议的变化，对筛查方案的有效性。报告了细胞学结果分布的变化，宫颈上皮内瘤变（CIN）病变的检出率和宫颈鳞状癌的检出率。方法：从大阿姆斯特丹地区的7个实验室检索1990年至2000年在全国组织病理学和细胞病理学数据库（PALGA）中登记的所有妇科细胞学和组织学检查结果。结果：引入cisoa分级后，诊断模棱两可的细胞学结果从11.3%显著下降到2.6%，中度核不良或更严重的比例未增加。在研究期间，组织学诊断的高级别CIN病变的检出率从4.1 /1000涂片显著增加到6.4/1000涂片，而低级别病变和浸润性宫颈癌的检出率没有变化。结论：引入新的cisoa分级系统后，结果模棱两可和重复推荐的情况大幅减少，高分级病变的检出率未下降，使筛查方案更加有效。
Aim: To describe the effect of introducing the CISOE-A framework for reporting cervical cytology results, including changes in repeat and referral advice in the Netherlands, on the efficacy of the screening programme. Changes in the distribution of cytological results, the detection rate of cervical intraepithelial neoplasia (CIN) lesions, and the detection rate of squamous cervical carcinoma are reported.Methods: The results of all gynaecology cytological and histological examinations, as registered in the nationwide database for histopathology and cytopathology (PALGA) from 1990 to 2000, were retrieved from seven laboratories in the greater Amsterdam area.Results: After the introduction of the CISOE-A classification, cytological results with equivocal diagnoses decreased significantly from 11.3% to 2.6%, without an increase in the percentages of moderate dyskaryosis or worse. During the study period, the detection rate of histologically diagnosed high grade CIN lesions increased significantly from 4.1 to 6.4/1000 smears, whereas there was no change in the detection rates of low grade lesions or invasive cervical cancer.Conclusions: The introduction of the new CISOE-A classification system resulted in a substantial decrease of equivocal results and repeat recommendations, without a decrease in the detection rate of high grade lesions, making the screening programme more efficacious.