EVALUATION OF THE PAPNET SYSTEM FOR PRESCREENING TRIAGE OF CERVICOVAGINAL SMEARS

OBJECTIVE: To assess the PAPNET System for prescreening triage of cerv ical smears. STUDY DESIGN: We prospectively prescreened 5,170 consecut ive cervicovaginal smears with the PAPNET System. The slides were then manually screened by cytotechnologists blinded to the PAPNET diagnose s. Cases identified as abnormal by either PAPNET or manual screening w ere reviewed by a cytopathologist. The PAPNET and manual diagnoses wer e correlated. RESULTS: Diagnostic concordance between PAPNET and manua l screening was seen in 4,340 (84%) of the cases (3,167 negative, 1,03 8 abnormal and 135 unsatisfactory). Noncorrelation between PAPNET and manual diagnosis occurred in 794 cases (543 abnormal by PAPNET and neg ative manually, 228 negative by PAPNET and abnormal manually, 8 abnorm al by PAPNET and unsatisfactory manually, 29 unsatisfactory by PAPNET and negative manually, 7 negative by PAPNET and unsatisfactory manuall y). The diagnostic sensitivity of the PAPNET System was 82%, diagnosti c specificity 85%, predictive value of a positive test 66% and predict ive value of a negative test 93.4%. The false negative fraction of PAP NET was 6.4% for low grade squamous intraepithelial lesion and above. CONCLUSION: PAPNET performed effectively for prescreening triage, incr easing the accuracy of screening and reducing the screening time.