Diagnostic Value of Combination of ThinPrep Imaging System with Manual Screening in 257,047 Cases of Cervical Cancer Screening by Thinprep Cytologic Test

Objective: To analyze the diagnostic value of manual screening in combination with ThinPrep Imaging System (TIS) versus manual screening alone in cytology screening of cervical cancer. To compare positive predictive value (PPV) and negative predictive value (NPV) for cervical high-grade disease. Methods: A total of 257,047 cases dated from June 2015 to December 2021 were tested by ThinPrep cytologic test (TCT) retrospectively by West area of Shanghai First Maternity and Infant Hospital. Among them, 125,917 cases were interpreted by manual screening in combination with TIS (TIS group) and 131,130 cases were interpreted by manual screening (manual screening group). Atypical squamous cells of undetermined significance (ASCUS) and the above lesions were listed as cytologically positive cases that may have high-grade and above lesions, of which HSIL + SCC + AIS + IAC are cytologically positive cases with clear high-grade and above lesions. Low-grade Squamous Intraepithelial Lesions (LISL) and above lesions were listed as histologically positive cases. of which HSIL + SCC + AIS + IAC are histologically high-grade disease (HGD). Based on the results of the pathological tissue biopsy, positive and negative predictive value of the two groups were analyzed and compared. Results: Among 125,917 patients in the TIS group, 21,959 patients underwent colposcopy and cervical pathological biopsy. Compared with the manual screening group, the interpretation proportion of ASCUS in TIS group was significantly decreased ( P < 0. 05). Manual screening in combination with TIS can significantly improve positive and negative predictive value of ASCUS, ASC-H, LSIL, HSIL and AGC-FN, not AGC-NOS. Conclusions: TCT by manual screening in combination with TIS has a high predictive accuracy for early low-grade and high-grade cervical cancer lesions. TIS in combination with manual screening can significantly reduce the interpretation rate of ASCUS, and the false negative rate in TCT, and TIS in combination with manual screening can increase the interpretation rate of precancerous cervical lesions.