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Updated: Sep 9, 2025

Digital Analysis of Immunostaining of ZW10 Interacting Protein in Human Lung Tissues
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Cytology Screening Using Z-Stack Digital Slides: A Validation Study.

Kei Tanaka1, Kris Lami1, Takuma Odate1

  • 1Department of Pathology Informatics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Diagnostic Cytopathology
|August 29, 2025
PubMed
Summary
This summary is machine-generated.

Z-stack whole slide imaging (z-WSI) shows potential for cervical cytology screening, though diagnostic agreement is slightly reduced compared to glass slides. Targeted training may improve accuracy and efficiency for digital pathology workflows.

Keywords:
computer‐assisted cervical cancercytopathology cytological techniquesdiagnosis

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Area of Science:

  • Digital pathology
  • Cytopathology
  • Medical imaging

Background:

  • Digital pathology faces challenges in precision and data volume for cytology applications.
  • Whole slide imaging (WSI) offers potential but requires validation against conventional methods.

Purpose of the Study:

  • To compare diagnostic accuracy, screening time, and observer agreement between z-stack WSI (z-WSI) and conventional glass slides for liquid-based cervical cytology (LBC).

Main Methods:

  • 91 LBC samples (NILM, LSIL, HSIL, SCC) were evaluated by four cytotechnologists using both glass slides and z-WSI.
  • Two classification schemas were used: "Screening-2-Category" (normal vs. abnormal) and "Morpho-3-Category" (normal vs. low-grade vs. high-grade lesions).

Main Results:

  • Inter-observer agreement was slightly reduced with z-WSI compared to glass slides for both classification schemas.
  • Diagnostic accuracy showed no significant differences between z-WSI and glass slides.
  • Screening time was 2-5 minutes longer on average with z-WSI.

Conclusions:

  • z-WSI is a potential tool for cytology screening but not fully equivalent to glass slides.
  • Specific training for WSI is recommended to enhance diagnostic accuracy and workflow efficiency.