Home » Courses » Κυτταρολογία τραχήλου της μήτρας » 11. Διασφάλιση ποιότητας, έλεγχος ποιότητας και προδιαγραφές ποιότητας » Κυτταρολογικός έλεγχος (screening)

Κυτταρολογία τραχήλου της μήτρας

Κυτταρολογικός έλεγχος (screening)

? ????????? ??????????? ???? ?????? ????????? ?????????????? ????????? ??? ????????? ?????????? ????????? ?????? ?????? ???????? ???????? ??????? ?????? ??????????, ????? ??? ????? ??? ???????????? ??? ???????? ????????, ??????????? ??? ????????. ??? ??????????????? ?? ??? ?????? ????????? ???? ?????? (screening) ??? ??? ??????? ?? ???????????.

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  • ??????????, ??? ????? ??? ???????????? ?????????? ?? ??? ????? ? ????????? ?????? ? ????????????????  ???? ???? ????????????????? ???????.
  • ??????????? ??? ??????????? ???????, ????? ???????? ? ??????? ???????? ?? ?????? ????????? ?????? ?????? ?? ????????? ?? ??????? ????????????.
  • ?????????? ?????????????, ? ????????? ??? ??? ?? ??????????? ???????? ?????? ?? ?????????? ??? ?? ????? ?????, ?????? ?? ???????? ??????? ????? ???? ?? ?????????? ???????? ????????.
  • ???????????  ????? ?????????? ?????????? ??? ??? ?????????????? ???? ??? ?????????? ?????? ?? ???????? ????????? ????????????? ?? ?????????????? ?? ???? ????.
  • ? ?????????? ??????? ??????? ????????? ???? ?? ???????? ??? ????? ?????? ?????? ?? ???????? ?? ??????? ????????????.
  • ???????? ??????? ??? ????? ???? ??????????? ?????? ?????? ?? ???????? ?? ?? ?????????? ?????????
  • ????? ??????? ?? ?????? ?? ?????????? ????????? ?????? ?? ???????? ?? ????-???????? ???????? ?????????? ?????????? ?? ?????? ? ??????? (borderline).

 

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  • ?? ????????????? ?????? ??? ?????????? ??????? ??? ???????????? ?????? ?? ????????? ?? ????????? ???????? ??? ?? ?????????? ??? ???????.
  • ????? ???? ??????? ? ???????????? ?????????? ??? ????????????? ??? ????? ?????????????? ??? ???????????
  • ????????? ????? ??? ????????, ???????????, ????????????? ???..

 

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  • ?????, ???? ??? ???? ??????? ??????????? ?? ??? ???????????? ???? ??? ????????? ?????? (screening) ?? ?? ????????? ? ?????-????? ???????????? (Demay 2000; Gupta et al. 2013; Leung et al. 2008; Mitchell & Medley1995).
  • ?????????????? ??????????? ?????????? ?????? ?????? ?? ??????????? ??? ?? ????????? ??? ????????? ??? ??????? ??? ???????????? ? ??? ??????????? ???? ?????-????? ???????????? (Demay 2000; Gupta et al. 2013; Robertson & Woodend 1993).
  • ???????? ????????? ??????????????? ?? ???????????? ????????????? ???????
  • ????? ???????? ?? ???????????? ????????s ??? ???????? ?????? ?? ????????? ??? ?????????? ??? ??????? (screening) (Evans et al. 2011).

 

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????????????? ??? ????????????? ?????????? ??? ??????????????? ??  ??????????.

??????? ???????????, ???????????? ? ???????????? ??? ??????????????? ?? ?????????????.

 

?????? ????????? ???? ????????? ?????? (screening)

  • ??????????, ???????????, ?????????? ????????????? ??? ????? ?????? ?? ??????? ??????????? ?? ????????? ?? ???????? ????? ??? ??? ???? ??? ????????? ??? ??????? ?????????????
  • ?????? ????????, ?????????? ???????? ??? ??????? ?????????? ?????? ?? ???????? ?? ???????? ??????? (screening)
  • ???????? ??????????? ?????? ?? ??????????? ??? ??????? ????????????????? ???????????

 

??????? ??? ?????? ????????? ??? ?????????? ?????????

?????????? ??? ??????? ????????? ??? ???????????? ????? ??????????? ??? ???? ??? ???????? (QC).

?????????? (Rescreening) ????????? ???? ??? ?????? ??? ??????? ????????????? ????? ??? ??????? ??????? ?????????? ??????? ??? ????????? ??? ??????????? ???? ?????????? ?????????????? ??????? ??? ??? ???? ????????? ??? ????? ??? ??????? ??? 10% ??? ?????? ??????????? ??? ????????? (full rescreening of slides) (Wiener et al. 2007; Arbyn et al. 2003).  ???????? ??????? ???????:

 

?????? ?????????? (rescreening)

?????? ?????????? (rescreening) ???? ?????????? ???  ????? ??? ?????????????? ??????? ????????? ??? ?????? ????????? ??????????? ??? ?????????? ?? ??????? ? ??????????? (Faraker & Boxer 1996)

  • ???? ???????? ???????????? ????????? ??? 1 ????? ?? x10 ????????? ??? ?? ????? ????????? ????????????? ???? ?????????? ???????????. 
  • ????????? ?????????? ??????? ??????? ??? ???? Dudding et al. (2001) ??? ????? ??????????? ?????????????? ?????????? ?? ??? ??? ? ?????? ?????????? (????? 11.1).  ? ???????? ?????? ??????????? ??????? ?? ????????? ??? ?? ????????? ???? ??? ?????????? ???????????? ??? 50 ????????????.
  • ?????? ?????????? (rescreening) ???? ?????? ??? ????? ??????????? ??????????????  ???? ???????? ??? ???????? ?????? ????????? ?????????? ?? ??? ????? ?????????? 10% ??? ????????? (Manrique et al. 2006).  ?????? ?????????? (rescreening) ???? ??? ????????? ??? ????????? ????????? ???????? ??? ??????????? ?????? ??? ????????? ?????? ????????? ??? ?????? ????????, ???? ?? ?????????? (rescreening) ???? ?? ???-?????? (pre-screening) (NHSCSP 2013).
????? 11.1. ???????? ??? ?????? ?????????? (rescreening) ??? ???????????? ????????????: ????? 1 ??? ???? Dudding et al. 2001

 

????? ???-??????? (pre-screening)

????? ???-??????? (pre-screening) ???? ??? ????????? ???? ?? ????? ? ??????? ???????? (?? ??????????? ??????? ????????????? ???? ??? ??????????? ??? ????????) ??????? ??? ????? ?????? ?????????? ?? ??? ?????? ?????????? (Arbyn et al. 2003). 

  • ???-??????? (Pre-screening) ???? ?? ??????????? ??? ????????? ??? ????????????? ??? ??????????? ??????????? (rescreening) ??? ??? ??????????? ??? (?? ????? ?? ?? ?????? ??????????) ????????????? ?? ??? ??????? ??? ??????????? ???????. 
  • ????? ???-??????? (pre-screening) ????? ??? ?????????? ??? ?????????????? ??? ??? ?????????? (rescreening) ????????? ????????? ????? ???????? ??????????? ?? ??????????? ??????? ???? ?????????, ??? ???? ?????? ???????? ???? ?????????? (Evans et al. 2011).
  • ???-??????? (pre-screening) ???? ?????????? ??? ????? ??? ?????????? ???? ???????????? ?????-????? ?? ????? ?? ?? ????????? (Dudding et al. 2011a) ??? ? ?????????? ??? ?????? ?? ????????? ?? ????? ?????? (Dudding et al. 2011b).  

 

????????????????? ??????? (screening)

????????????????? ??????? ????? ??????? ???? ?????? ?? ??????? ????? ??? ?????? ????????? ??? ??????? ??? ????????? ??? ?????????????? ?? ??? ??????? ???-??????? (pre-screening) ????????????? ??? ??? ????? ????????? ?????? (Heard et al. 2013). ???????? ?? ??? ?????? ?????????? (rescreening) ? ???? ???-?????? (pre-screening), ? ????????????????? ??????? ????? ??????????? ???? ?????????? ??? ? ??????? ??? ??????????? ??????? (screening) (Roberts et al. 2007) ??? ??? ????? ??? ???? ???? ????????????. 

 

?????????? ??? ?????????? ??? ????????? ????????????? ???????? ??? ??????????? ??????? (screening)

?????? ?????????? (review), ????? ???-??????? (pre-screening) ??? 10% ?????? ??????????? ???????? ???????? ??? ????????? ??? ????????? ?????????? ????????? ??? ?????????? ??? ????????? ????????????? ???????? ??? ??????????? ??????? (screening), ??? ???????? ??????? ?????? ??? ??????????? ???? ? ???????????? ??????????????? ?? ?? ????? ???? ??????? ? ?? ???? ???????? ???? ??? ????????? HPV ??????. 

 

?????????? ??? ??????????? ??????? (screening)

??????? ???????????? ?? ????????????  x 100
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??????? ?? ???????????? ???????? ?????????????  (ASC-US+ ? HSIL+)

 

???? ????? ?? ??????? ??????????? (rescreening) ? ???-??????? (pre-screening) ?????????? ????????? ???? ??? ?????? ?????? ??? ????????????? ???? ?????????? ???? ????? ???????? ?????????: 0.18% (CI 0.14-0.21%) ??? ?????? ?????????? (rescreening) ??? 0.19% (CI 0.03-0.35%) ??? ???? ???-?????? (pre-screening) (Arbyn et al. 2003). ???? ? ????? ?????? ???? ?????????? ??????? ??? ?????? ???????? ??? ??? ?????????? ??? ???????? ??? ???????????? ???? ?? ?????? ?? ???????????? ??? ??????? ??? ???????? ??????????.

  • ?????????? ??? ‘????????? ??????? (screening errors)’ ?? ?????? ?? ????? ???????????? ??? ????????? ??????????? ????? ??? ????? ??? ? ??? ?????? ???????????? ?????? ?? ?????????? ??????? ????? ??????-?????? ?????????.  
  • ??????????? ?????????, ???? ? ????????? ?????????? ? ?????????, ?? ?????? ?? ???????????? ???? ???? ??????????? ??? ?????? ??????? ????????.
  • ?????? ? ?????? ?????? ????????????? ????????? ??? ??? ???????? ??? ????????????, ? ?????????? ??? ??????? (screening) ?? ?????? ?? ???????????? ??? ??? ???????? ???????????? ??? ??????? ???????? ????????????? ????? ??? ???????????.
  • ??????????? ?????? ??????? ????????, ???? ??????????? ?????? ????????, ????????? ?????????? ??? ?? ?????????????? ????????????? ???????? ?? ?????? ?? ???????????????? ????????.

 

QC ??? QA ???? ????????? ?????? (screening)

  • ??????? ????????? ???? ?????? ??? ?????????? ??? ???????????? ????????? ??? ???????
  • 100%  ??????? ??????????? (rescreening) ?????????? ???????? ?????? ???????? ???? ??? ?????? ??? ??????? ?????????????
  • ???? ??? ?? ??? ??????? ???????, ? ???????? ??? ??????? (screening) ????????? ??? ??? ????????????? ????????, ??? ????????? ??? ?? ????? ????????, ??? ?? ?????? ?? ??????????? ????? ???? ??? ???????????? ‘????????? ??????? (screening errors)’

 

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