PubMed · 4185270
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V M Prokoptsev, M M Boĭnovich. 1969. [Automatic apparatus for amperometric titration].. https://pubmed.ncbi.nlm.nih.gov/4185270/
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For this study, bladder washings of 923 patients with a follow-up for superficial bladder cancer were used. For the prognostication of each case (follow-up period up to 20 mo), two parameters were used: tumor recurrence and the event of (progressing) invasive growth. Each sample was classified as negative, low grade or high grade, based on confocal-aided architectural cytology. The feature architecture was based on the images of the epithelial fragments as seen in the Feulgen stain, which also could be visualized in confocal microscopy. The same three classes were also used for grading the samples according to the QUANTICYT system, in which DNA and morphometry of nuclei were automatically assessed. The 532 cases graded as QUANTICYT high had a worse prognosis than the 391 cases with QUANTICYT low. In addition, architectural cytology contributed significantly for the prognostication of cases classified as QUANTICYT high, the 228 nonconcording cases faring better than the 304 concording ones. For QUANTICYT low, the 156 nonconcording cases had also a lower recurrence rate than the 235 concording ones, but this difference was only significant in patients followed for up to 8 mo. These findings indicate that QUANTICYT grading supplemented by architectural cytology supplies the clinician with valuable prognostic information which can be used to limit cystoscopies.
Despite the overwhelming interest in the development of several computer based technologies in the last several years, the role of automation in cytology has remained controversial. The potential of these technologies in the reduction of false negative results in pap smears is well recognized. However, there is still remarkable confusion as how to incorporate automation in the routine practice of cytology. This prompted the New Technology Task Force of the George Papanicolaou Society of Cytopathology to design a survey to seek the opinion of those engaged in cervicovaginal cytology screening regarding the value of automation in cytology. In 1996, a ten question survey was sent to 1800 cytopathology laboratories throughout the nation. The response rate was 23% (416/1800). The responders represented laboratories varying from those with less than 5,000 pap smears to those with over 100,000 cases per year. The majority of the responders did not believe that automation is essential for cervicovaginal cytology. This was evidenced by the fact that only 12% of the laboratories were engaged in automated cytology and predominantly used it for quality control measures. The inability of small laboratories to absorb the extra expense involved in the integration of automated cytology in their practice, particularly in the current era of managed care was a major concern. There was also concern about the potential for compromise of patient care by the drive for corporate profits and the dissemination of wrong information to the public and physicians. Suggestions most frequently proposed included appropriate patient and physician education about the merits and pitfalls of the pap smear, and also endorsing an affordable universal fee for pap smears. Rescreening for all pap smears, reassessing the benefits of automation in cytology and development of the standards were other proposals. Partnership with larger cytology laboratories, creation of "cytology consortiums" with shared resources to provide regionalized automated rescreening services were also strongly suggested. This survey clearly indicates the need for further evaluation of automation in cytopathology and a focused attention to various issues surrounding cervicovaginal cytology screening.