Lazcano Ponce E C, de Ruiz P A, Martínez Arias C, Murguía Riechers L
Centro de Investigaciones en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
Rev Invest Clin. 1997 Mar-Apr;49(2):111-6.
To evaluate the diagnostic agreement in Papanicolaou of pathologists and cytotechnologists using kappa values for concordancy.
The diagnostic variation was estimated in 20 gynecological cytology (Pap) specimens by 30 pathologists and 7 cytotechnologists attending the XXXVII Congress of the Mexican Association of Pathologists in 1994.
The best concordancy versus an expert was in tumoral diathesis (pathologists' kappa = 0.36; cytotechnologists' kappa = 0.35) and kollocytos (pathologists' kappa = 0.55; cytotechnologists' kappa = 0.36). The least concordancy was observed in anisonucleosis (pathologists' kappa = 0.11; cytotechnologists' kappa = 0.02), nuclear hyperchromasia (pathologists' and cytotechnologists' kappa = 0.11) and dyskeratosis (pathologists' kappa = 0.11; cytotechnologists' kappa = 0.16). The kappa values for cervical neoplasia showed poor agreement, and in invasive cervical cancer it was 0.30.
There was a low concordancy of Pap diagnosis in the study. It is convenient to try to improve the concordancy of cytologic diagnosis in Mexico. One strategy could be the use of a uniform diagnostic criteria and the adoption of a single nomenclature.
使用一致性kappa值评估病理学家和细胞技术人员在巴氏涂片检查中的诊断一致性。
1994年参加墨西哥病理学家协会第三十七届大会的30名病理学家和7名细胞技术人员对20份妇科细胞学（巴氏）标本的诊断差异进行了评估。
与专家相比，一致性最好的是肿瘤素质（病理学家的kappa值 = 0.36；细胞技术人员的kappa值 = 0.35）和挖空细胞（病理学家的kappa值 = 0.55；细胞技术人员的kappa值 = 0.36）。在核大小不一（病理学家的kappa值 = 0.11；细胞技术人员的kappa值 = 0.02）、核深染（病理学家和细胞技术人员的kappa值 = 0.11）和角化不良（病理学家的kappa值 = 0.11；细胞技术人员的kappa值 = 0.16）方面观察到的一致性最低。宫颈肿瘤的kappa值显示一致性较差，浸润性宫颈癌的kappa值为0.30。
本研究中巴氏涂片诊断的一致性较低。在墨西哥，尝试提高细胞学诊断的一致性是适宜的。一种策略可能是使用统一的诊断标准并采用单一的命名法。
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