Butland D, Herbert A
Histopathology Department, Southampton General Hospital, UK.
Cytopathology. 1996 Dec;7(6):391-9. doi: 10.1111/j.1365-2303.1996.tb00544.x.
Reporting rates for abnormal and inadequate cervical smears have been compared during a 5-year period in nine laboratories and related to targets and achievable ranges recently recommended by the National Health Service Cervical Screening Programme (NHSCSP). There was improved consistency in rates for all grades of abnormality as well as inadequate smears. The average rate for moderate and severe dyskaryosis combined increased to 1.6%, which is the target recommended by the NHSCSP, and the standard deviation fell from 0.52 to 0.27. Although average rates for mild dyskaryosis and borderline nuclear change combined and inadequate smears both remained within the achievable range recommended by the NHSCSP, four laboratories were above the upper limit for each of those categories in the final year. During the 5 years of the study there was a fall in the number of 'inflammatory' smears coded as negative with a recommendation for early repeat. Only one laboratory still uses that category. The challenge for the future lies in controlling high rates for minor abnormalities and inadequate smears while maintaining acceptable rates for moderate and severe dyskaryosis. Comparison of reporting rates is regarded by the participating laboratories as a useful adjunct to external quality assurance.
在九年时间里，对九个实验室五年间异常及不合格宫颈涂片的报告率进行了比较，并与英国国家医疗服务体系宫颈筛查计划（NHSCSP）最近推荐的目标及可实现范围相关联。所有等级异常以及不合格涂片的报告率一致性均有所提高。中度和重度核异质合并的平均报告率升至1.6%，这是NHSCSP推荐的目标，标准差从0.52降至0.27。尽管轻度核异质和核周界改变合并以及不合格涂片的平均报告率仍处于NHSCSP推荐的可实现范围内，但在最后一年，有四个实验室超出了这些类别各自的上限。在研究的五年中，编码为阴性且建议早期复查的“炎症性”涂片数量有所下降。只有一个实验室仍在使用该类别。未来的挑战在于控制轻微异常和不合格涂片的高报告率，同时保持中度和重度核异质的可接受报告率。参与研究的实验室认为，报告率的比较是外部质量保证的有益辅助手段。
