The Comparative Study Of Diagnostic Value Of Modified Pastometer Smears Test And Liquid-based Cytological Test On The Diagnosis Of Cervical Intraepithelial Neoplasm

Objective:The pathology results of the cervical biopsy under the guidance of colposcopy were the gold standard. The purpose of this study was to investigate the detection accuracy of liquid-based cytological test and modified pastometer smears on the diagnosis of cervical intraepithelial neoplasm.Methods:From January 2008 to October 2009,500 women, who visited the department of gynaecology and obstetrics out-patient clinic, were selected for the study. All the women were received modified pastometer smears test and liquid-based cytological test. The difference between two tests was compared. In addition,445 women were detected with colposcopy and the cervical biopsies were done for pathological examination. The pathological examination results were the gold standard. The accuracy of two cytological tests on the diagnosis of cervical intraepithelial neoplasm was compared.Results:①In 500 examined women, the consistency of two cytological tests was 87.20%. Liquid-based cytological test could improved significantly detection rate of LISL(x2=11.42,P<0.05).②In 445 colposcopy examined women, the pathological examination results were:negative/cervical dysplasia is 306(68.76%), CINⅠis 99(22.25%),CINⅡ,Ⅲis 38(8.54%)),SCC is 2(0.45%).③Comparatively,the detection rate of modified pastometer smears test and liquid-based cytological test showed statisitical significance (x2=5.23,P<0.05) whose consistency was 90.34%, misdignosis4.58%,rate of missed dignosis 20.86.Detection rate of cervix uteri LISL in pathological examination cervix uteri CIN was 79.14%.Detection rate of carvixuteri HSIL in pathological examination cervix uteri CIN IIwas72.50%.Detection rate of cancer in pathological examination was 50.0%.④In Liquid-based cytological test,the detection rate of cervix uteri LSIL(26.74%)and pathological examination cervix uteri(31.24%) showed statistical significance(x2=4.708,P<0.05)whose consistency was87.64%,misdignosis 11.44%,rate of missed dignosis 14.39%;Detection rate of cervix uteri LSIL in pathological examination cervix uteri CIN was 85.61%.Detection rate of cervix uteri HSIL in pathological examination cervix uteri CINⅡwas 75.0%, Detection rate of cancer in pathological examination cervical cancer was50.0%.⑤The consistent rate of two cervix uteri cytological tests and pathological examination showed no significant difference(x2=1.65,P>0.05);According to golden standand,detecting sensibility and missed diagnosis of cervix uteri CIN in two cytological test showed no significant difference(x2=2.007, P>0.05),however specificity and rate of missed diagnosis of them have statistical significance (x2=9.783, P>0.05). Modified pastometer smears test and TCT Youden's index was 0.742 and 0.746,Positive predictive vale was 0.773 and 0.887,Negative predictive vale was 0.931 and 0.910.Conclusions:Modified pastometer smears test and TCT had similar consistency and accuracy on the diagnosis of CIN. As to above LSIL, the detection rate of TCT was higher than that of modified pastometer smears test, and the rate of missed diagnosis was higher too. So the modified pastometer smears test had some clinical value on the diagnosis of CIN.