title: Performance of the AutoPap Primary Screening System in the detection of high-risk cases in cervicovaginal smears.
abstract: OBJECTIVE
  To assess the performance of the AutoPap Primary Screening System (APSS) (TriPath Imaging, Inc., Burlington, North Carolina, U.S.A.) for the detection of high grade cervical squamous intraepithelial lesions and invasive cervical cancer.
  
  
  METHODS
  A total of 14,779 consecutive conventional Pap smears were processed by the APSS. All slides designated as "Review" by the device were manually screened according to the Bethesda System. The ranking scores obtained from the device were compared with the cytologic interpretations in all cases and with the final histologic diagnoses in the cases with cytologic severe abnormalities.
  
  
  RESULTS
  The device classified 10,349 slides as Review (78%) and 2,912 (22%) as "No Further Review." In the 78% Review cases, the samples were ranked in descending order of potential abnormality, broken into quintiles. The correlation between the slide quintile ranks and the manual cytologic diagnosis indicated that 90% of abnormal smears were categorized by the device as in the first and second quintile rank, and the correlation between the rank report of the device and the histologic diagnosis showed that all cases of HSIL or invasive carcinoma were in the top two ranks. No significant abnormalities were observed in any of the smears categorized as No Further Review.
  
  
  CONCLUSIONS
  This study confirmed the effectiveness of APSS for the detection of Pap smears with severe abnormalities.
authors.affiliation: Department of Pathology, Istituto Nazionale Per lo Studio e la Cura dei Tumori, Milan, Italy.
authors.forename: L M
authors.initials: LM
authors.lastname: Alasio
authors.forename: C
authors.initials: C
authors.lastname: Alphandery
authors.forename: P
authors.initials: P
authors.lastname: Grassi
authors.forename: M
authors.initials: M
authors.lastname: Ruggeri
authors.forename: G
authors.initials: G
authors.lastname: De Palo
authors.forename: S
authors.initials: S
authors.lastname: Pilotti
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D065006:Papanicolaou Test; D011933:Reagent Kits, Diagnostic; D012307:Risk Factors; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014626:Vaginal Smears / Q000379:methods; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology
chemical_list: D011933:Reagent Kits, Diagnostic