Low grade squamous intraepithelial lesion, epithelial cell abnormality-adjusted workload, and the ThinPrep imaging...

Area of Science:

• Cytopathology
• Medical Imaging Technology
• Public Health

Background:

• Previous research indicated a negative correlation between ThinPrep Imaging System (TIS) screening sensitivity and epithelial cell abnormality (ECA) adjusted workload for ASCUS and HSIL detection.
• The relationship between TIS screening sensitivity and ECA-adjusted workload at the LSIL threshold remained less defined.

Purpose of the Study:

• To investigate the correlation between TIS screening sensitivity and ECA-adjusted workload specifically at the threshold for low-grade squamous intraepithelial lesion (LSIL).
• To determine an optimal workload for TIS to achieve maximum screening sensitivity for LSIL detection.

Main Methods:

• Meta-analysis of data from seven published manuscripts containing relevant information on TIS screening.
• Statistical correlation analysis (linear regression) to assess the relationship between changes in TIS sensitivity and ECA-adjusted workload.
• Extrapolation of data to determine workload required for 100% sensitivity at the LSIL threshold.

Main Results:

• A negative correlation was observed between the change in TIS screening sensitivity and ECA-adjusted workload (y = -3.75x + 54, R(2) = 0.104).
• An ECA-adjusted workload of approximately seven slides/day was predicted to achieve 100% sensitivity for LSIL detection.
• This workload is comparable to that achieving 100% sensitivity for ASCUS and slightly higher than for HSIL.

Conclusions:

• The ECA-adjusted workload is a valid metric for assessing TIS workload in LSIL screening.
• Laboratories utilizing TIS should maintain a maximum workload of seven ECA-adjusted slides per day to ensure optimal screening sensitivity.
• Recommended maximum daily actual slides: 700/ECA percentage.