Layfield Lester J, Wang Guoliang, Yang Zhongbo Jerry, Gomez-Fernandez Carmen, Esebua Magda, Schmidt Robert L
Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, Missouri, USA,
Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, Missouri, USA.
Acta Cytol. 2020;64(5):413-419. doi: 10.1159/000506757. Epub 2020 May 19.
A number of guidelines have been developed to improve standardization of the terminology and criteria for cytologic specimens obtained from the thyroid, pancreas, lung, and salivary glands. A major goal of these guidelines is to improve reproducibility and understanding of the reporting of diagnostic results among cytopathologists and between cytopathologists and clinicians. The International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology (IAC YSRB) is the most recent of these guidelines. The value of this system is, in part, dependent upon interobserver reproducibility.
Ninety consecutive fine-needle aspiration biopsies (FNAB) of the breast, performed over a 6-year period, were independently evaluated by 4 board-certified pathologists blinded to the original diagnoses. The 5 diagnostic categories used were those of the IAC YSRB according to published criteria for these categories. Observed agreement and chance corrected agreement (Fliess κ) were calculated. Differences in κ values were evaluated using the T statistic of Gwent. Statistical calculations were performed using STATA v16.0 (STATA Corp., College Station, TX, USA).
Overall agreement between observers was good. Observed unweighted agreement was 69% and weighted agreement was 91%. The majority of diagnoses were concordant (68.6%).
Interobserver agreement of 4 cytopathologists was good using the 5 categories of the IAC YRSB (69%). Agreement was greater among pathologists with more years of experience. The IAC YSRB system appears to provide greater agreement among viewers than guidelines for cytologic specimens obtained from some other body sites (salivary gland and lung). Most discrepancies were only by a single category, with only 22/113 (19%) differing by more than one category.
已经制定了一些指南，以提高从甲状腺、胰腺、肺和唾液腺获取的细胞学标本的术语和标准的标准化。这些指南的一个主要目标是提高细胞病理学家之间以及细胞病理学家与临床医生之间诊断结果报告的可重复性和理解性。国际细胞学会横滨乳腺细针穿刺活检细胞病理学报告系统（IAC YSRB）是这些指南中最新的一个。该系统的价值部分取决于观察者间的可重复性。
在6年期间对90例连续的乳腺细针穿刺活检（FNAB）进行了独立评估，由4名对原始诊断不知情的经过委员会认证的病理学家进行评估。使用的5种诊断类别是根据IAC YSRB公布的这些类别的标准确定的。计算了观察到的一致性和校正机遇后的一致性（Fliess κ）。使用Gwent的T统计量评估κ值的差异。使用STATA v16.0（美国德克萨斯州大学城的STATA公司）进行统计计算。
观察者之间的总体一致性良好。观察到的未加权一致性为69%，加权一致性为91%。大多数诊断结果是一致的（68.6%）。
使用IAC YRSB的5个类别时，4名细胞病理学家之间的观察者间一致性良好（69%）。经验更丰富的病理学家之间的一致性更高。与从其他一些身体部位（唾液腺和肺）获取的细胞学标本的指南相比，IAC YSRB系统似乎在观察者之间提供了更高的一致性。大多数差异仅为一个类别，只有22/113（19%）的差异超过一个类别。
