背景:早期食管鳞状细胞癌(ESCC)的细胞学检测仍然具有挑战性。因此,我们引入了一种快速细胞学筛查方法,并评估了其作为早期ESCC和前体病变的内镜检查前筛查的疗效.方法:该方法由海绵样本检索组成,自动液基细胞学治疗和载玻片制备,计算机辅助筛查和手动诊断。评估了早期ESCC和前体病变的检测功效。此外,将诊断效率与人工诊断进行比较.结果:83例早期ESCC和前体病变患者和2,090例无症状的ESCC高风险参与者被纳入。整个过程在两个工作日内完成。83例患者均检测到异常细胞,在2,090名无症状参与者中,有272名(13.01%)受试者。早期ESCC,高级别上皮内瘤变,低度上皮内瘤变和反流性食管炎和正常的内镜检查结果在8、13、11、187和53名异常细胞参与者中检测到,分别。计算的灵敏度,特异性,检测早期ESCC和前兆病变的阳性预测值和阴性预测值为100%,88.34%,11.76%,100%,分别。与手动诊断相比,该方法在较短的持续时间内完成(5.4±0.45分钟vs320.2±132.4分钟,p<0.001),更高的诊断准确性(96.7%vs74.4%,p=0.015)和更好的观察者间协议(93.3%vs66.7%,K=0.286,p<0.001)。结论:我们的研究为早期ESCC和前体病变的内镜检查前筛查提供了一种有前途的方法。
Background: Cytological detection of early esophageal squamous cell carcinoma (ESCC) remains challenging. Therefore, we introduced a rapid cytological screening method and evaluated its efficacy as a pre-endoscopy screening for early ESCC and precursor lesions. Methods: This method consisted of a sponge sample retrieval, automatic liquid-based cytological treatment and slides preparation, computer-assisted screening and manual diagnosis. Efficacy for detection of early ESCC and precursor lesions was evaluated. Also, diagnostic efficiency was compared with manual diagnosis. Results: Eighty-three patients with early ESCC and precursor lesions and 2,090 asymptomatic participants with high risks of ESCC were enrolled. Whole procedure was accomplished within two working days. Abnormal cells were detected in all 83 patients, and in 272 (13.01%) subjects among 2,090 asymptomatic participants. Early ESCC, high-grade intraepithelial neoplasia, low-grade intraepithelial neoplasia and reflux esophagitis and normal endoscopic findings were detected in 8, 13, 11, 187 and 53 participants with abnormal cells, respectively. The calculated sensitivity, specificity, positive predictive value and negative predictive value for detection of early ESCC and precursor lesions were 100%, 88.34%, 11.76%, and 100%, respectively. Compared with manual diagnosis, this method was accomplished in a shorter time duration (5.4 ± 0.45 min vs 320.2 ± 132.4 min, p < 0.001), a higher diagnostic accuracy (96.7% vs74.4%, p = 0.015) and a better inter-observer agreement (93.3% vs66.7%, K = 0.286, p < 0.001). Conclusions: Our study provides a promising methodology as pre-endoscopy screening for early ESCC and precursor lesions.