Objective:The accuracy of colposcopy-guided biopsy is key to the success of colposcopic triage in cervical cancer screening programs.However,there is no widely adopted biopsy guideline up to date.Our study aimed to de...Objective:The accuracy of colposcopy-guided biopsy is key to the success of colposcopic triage in cervical cancer screening programs.However,there is no widely adopted biopsy guideline up to date.Our study aimed to determine whether multi-quadrants biopsy improves the yield of cervical lesions.Methods:Eleven population-based cervical cancer screening studies were conducted in China.Cytology,highrisk human papillomavirus(hrHPV)testing and visual inspection were performed for primary screening.Females positive on one or more tests were referred for colposcopy and biopsy.The proportion of detected cervical intraepithelial neoplasia(CIN)2+and yields by quadrant lesion-targeted biopsy or 4-quadrant random biopsy were compared.Results:Among 4,923 females included,1,606 had quadrant lesion-targeted biopsy,and 3,317 had 4-quadrant random biopsy.The cumulative CIN2+yield increased from 0.10 for only one quadrant-targeted biopsy to 0.21,0.34,and 0.58 for at most two,three and four quadrants targeted biopsies.Among hrHPV positive females with high-grade squamous intraepithelial lesion(HSIL)+cytology,the cumulative CIN2+yield of a second targeted biopsy in another quadrant was significantly increased(P<0.05).Among hrHPV-negative females,the yield of 4-quadrant random biopsies was 0.005,and the yield by lesion-targeted biopsies was 0.017.For hrHPV positive females who had 4-quadrant random biopsy,the additional CIN2+yield for HSIL+,low-grade squamous intraepithelial lesion(LSIL)cytology,or abnormal visual inspection via acetic acid and Lugol’s iodine(VIA/VILI)were 0.46,0.11,0.14.Conclusions:A 4-quadrant random biopsy is recommended only for hrHPV positive females with HSIL cytology,and is acceptable if hrHPV positive with LSIL cytology or with abnormal VIA/VILI.Our findings add evidences for an objective and practical biopsy standard to guide colposcopy in cervical cancer screening programs in low-and middle-income countries.展开更多
针对传统蚁群算法在机器人路径规划中路径不是最短距离、运行时间长以及收敛速度慢等问题,提出多邻域蚁群算法(multi-neighborhood ant colony algorithm,ACO-MN)。为了解决路径不是最短距离的问题,引入多邻域搜索,使得搜索邻域扩大,机...针对传统蚁群算法在机器人路径规划中路径不是最短距离、运行时间长以及收敛速度慢等问题,提出多邻域蚁群算法(multi-neighborhood ant colony algorithm,ACO-MN)。为了解决路径不是最短距离的问题,引入多邻域搜索,使得搜索邻域扩大,机器人的路径距离减小;为了解决运行时间长的问题,在快速判断的基础上运用象限概率和象限概率控制参数,使得算法运行加快;为了解决收敛速度慢的问题,结合步长和邻域夹角改进启发函数,使得算法在后期的收敛速度加快。最后,在不同大小、不同复杂程度的栅格地图下,将ACO-MN与传统蚁群算法和其他改进算法进行仿真对比实验。实验表明,在小规模简单环境下ACO-MN的收敛速度相比于传统蚁群算法加快了76.19%,在大规模复杂环境下ACO-MN的运行时间相比于其他改进算法缩短了49.84%,最短路径缩短了5.6%,验证了该算法的有效性和优越性。展开更多
基金the Chinese Academy of Medical Sciences Initiative for Innovative Medicine(No.2016-I2M-1-019)the National Natural Science Foundation of China(No.81322040)。
文摘Objective:The accuracy of colposcopy-guided biopsy is key to the success of colposcopic triage in cervical cancer screening programs.However,there is no widely adopted biopsy guideline up to date.Our study aimed to determine whether multi-quadrants biopsy improves the yield of cervical lesions.Methods:Eleven population-based cervical cancer screening studies were conducted in China.Cytology,highrisk human papillomavirus(hrHPV)testing and visual inspection were performed for primary screening.Females positive on one or more tests were referred for colposcopy and biopsy.The proportion of detected cervical intraepithelial neoplasia(CIN)2+and yields by quadrant lesion-targeted biopsy or 4-quadrant random biopsy were compared.Results:Among 4,923 females included,1,606 had quadrant lesion-targeted biopsy,and 3,317 had 4-quadrant random biopsy.The cumulative CIN2+yield increased from 0.10 for only one quadrant-targeted biopsy to 0.21,0.34,and 0.58 for at most two,three and four quadrants targeted biopsies.Among hrHPV positive females with high-grade squamous intraepithelial lesion(HSIL)+cytology,the cumulative CIN2+yield of a second targeted biopsy in another quadrant was significantly increased(P<0.05).Among hrHPV-negative females,the yield of 4-quadrant random biopsies was 0.005,and the yield by lesion-targeted biopsies was 0.017.For hrHPV positive females who had 4-quadrant random biopsy,the additional CIN2+yield for HSIL+,low-grade squamous intraepithelial lesion(LSIL)cytology,or abnormal visual inspection via acetic acid and Lugol’s iodine(VIA/VILI)were 0.46,0.11,0.14.Conclusions:A 4-quadrant random biopsy is recommended only for hrHPV positive females with HSIL cytology,and is acceptable if hrHPV positive with LSIL cytology or with abnormal VIA/VILI.Our findings add evidences for an objective and practical biopsy standard to guide colposcopy in cervical cancer screening programs in low-and middle-income countries.
文摘针对传统蚁群算法在机器人路径规划中路径不是最短距离、运行时间长以及收敛速度慢等问题,提出多邻域蚁群算法(multi-neighborhood ant colony algorithm,ACO-MN)。为了解决路径不是最短距离的问题,引入多邻域搜索,使得搜索邻域扩大,机器人的路径距离减小;为了解决运行时间长的问题,在快速判断的基础上运用象限概率和象限概率控制参数,使得算法运行加快;为了解决收敛速度慢的问题,结合步长和邻域夹角改进启发函数,使得算法在后期的收敛速度加快。最后,在不同大小、不同复杂程度的栅格地图下,将ACO-MN与传统蚁群算法和其他改进算法进行仿真对比实验。实验表明,在小规模简单环境下ACO-MN的收敛速度相比于传统蚁群算法加快了76.19%,在大规模复杂环境下ACO-MN的运行时间相比于其他改进算法缩短了49.84%,最短路径缩短了5.6%,验证了该算法的有效性和优越性。
