Aplicación de la lectura automatizada de citología ginecológica. El punto de vista de los citotécnicos

The use of automated technologies in gynaecological cytology is increasing in many departments of pathology. Amongst other things, it allows the cytotechnician and the cytologist to focus on specific areas of the slide which enhances identification and therefore improves diagnosis. We have carried out a comparative study of 53.311 samples taken from the same number of women resident in Barcelona. We compared the efficiency of conventional cytology, liquid cytology (ThinPrep Pap Test®, TPPT, Hologic, Malborough, Massachussets) with manual reading and liquid cytology (ThinPrep Pap Test) with automated reading (Imager®, Hologic, Malborough Massachussets). Two aspects were evaluated: comparative global performance and performance in relation to patient follow-up. We found that automated readings increased the diagnosis of ASCUS and LSIL whilst the frequency of HSIL diagnosis remained similar. However, in patient follow-ups, we observed that more cases of HSIL were detected in women with previous diagnoses of ASCUS and LSIL when automated reading was used and that there was a significantly greater correlation between the cytological diagnosis and the findings on biopsy. We concluded that there is greater sensitivity for the diagnosis of ASCUS and LSIL as well as an increased specificity for the diagnosis of HSIL when automated readings of gynaecological cytology are used.