抽样误差作为不相关原因的有效性。

Validity of sampling error as a cause of noncorrelation.

作者信息

Hearp Matthew L, Locante Alberto M, Ben-Rubin Michelle, Dietrich Ruth, David Odile

机构信息

Department of Pathology, University of Illinois Medical Center, Chicago, Illinois 60612, USA.

出版信息

Cancer. 2007 Oct 25;111(5):275-9. doi: 10.1002/cncr.22945.

DOI:10.1002/cncr.22945

PMID:17665495

Abstract

BACKGROUND

Sampling error is a common explanation of noncorrelation in women whose Papanicolaou (Pap) tests show high-grade intraepithelial lesions (HSIL) but whose follow-up cervical biopsies show only cervical intraepithelial neoplasia (CIN) 1, koilocytosis, or reactive/inflammatory changes. The purpose of this study was to demonstrate the validity of sampling error in this setting by determining the proportion of negative colposcopic cervical biopsies in women with HSIL who subsequently undergo cone/loop electrode excision procedure (LEEP) biopsies or repeat cervical biopsies that confirm the diagnosis of high-grade CIN (HGCIN).

METHODS

In all, 368 cases of HSIL were retrieved from the computerized database from January 1, 2003 to December 31, 2005. Follow-up was obtained as part of routine quality assurance/quality control activities including cytologic-histologic correlation.

RESULTS

A total of 368 HSIL Pap diagnoses were retrieved. Of the 254 cases that were followed up by cervical biopsy, 146 showed HGCIN in the biopsy. Of the remaining 108 patients whose cervical biopsies failed to demonstrate HGCIN, 47 had a subsequent procedure, either cone/LEEP, cervical biopsy, or repeat Pap test. Cone biopsy/LEEP was performed in 34 cases (72.3%) with a diagnosis of HGCIN in 19. Repeat cervical biopsy was performed in 9 cases (19.1%) with HGCIN diagnosed in 5. Repeat Pap test was performed in 4 cases (8.5%) with HSIL diagnosed in 2.

CONCLUSIONS

In the population of women with HSIL by Pap test followed up by cervical biopsy with or without subsequent cone/LEEP, there was a discordant cervical biopsy rate for HGCIN of 43%. In the subgroup of women with HSIL by Pap test followed up by cervical biopsy and subsequent cone/LEEP or repeat cervical biopsy, the proportion of women with negative colposcopic cervical biopsy and subsequent histology-proven HGCIN was 56%. These figures justify sampling error as a valid cause of noncorrelation in women with HSIL followed up by cervical biopsy alone.

摘要

背景

对于巴氏试验显示高级别上皮内病变（HSIL）但后续宫颈活检仅显示宫颈上皮内瘤变（CIN）1、挖空细胞或反应性/炎症性改变的女性，取样误差是对其不相关性的常见解释。本研究的目的是通过确定HSIL女性中阴道镜下宫颈活检阴性的比例来证明在这种情况下取样误差的有效性，这些女性随后接受了锥形/环形电极切除术（LEEP）活检或重复宫颈活检，证实了高级别CIN（HGCIN）的诊断。

方法

从2003年1月1日至2005年12月31日的计算机数据库中检索出368例HSIL病例。随访是作为常规质量保证/质量控制活动的一部分进行的，包括细胞学-组织学相关性分析。

结果

共检索到368例HSIL巴氏诊断病例。在254例行宫颈活检随访的病例中，146例活检显示为HGCIN。其余108例宫颈活检未显示HGCIN的患者中，47例接受了后续检查，包括锥形/LEEP、宫颈活检或重复巴氏试验。34例（72.3%）进行了锥形活检/LEEP，其中19例诊断为HGCIN。9例（19.1%）进行了重复宫颈活检，其中5例诊断为HGCIN。4例（8.5%）进行了重复巴氏试验，其中2例诊断为HSIL。

结论

在巴氏试验为HSIL且接受了宫颈活检（无论是否随后进行锥形/LEEP）随访的女性人群中，HGCIN的宫颈活检不一致率为43%。在巴氏试验为HSIL且接受了宫颈活检以及随后的锥形/LEEP或重复宫颈活检的女性亚组中，阴道镜下宫颈活检阴性且随后经组织学证实为HGCIN的女性比例为56%。这些数据证明取样误差是仅接受宫颈活检随访的HSIL女性不相关性的一个有效原因。