[妇科细胞学诊断的一致性]

[Diagnostic concordance in gynecologic cytology].

作者信息

Lazcano Ponce E C, de Ruiz P A, Martínez Arias C, Murguía Riechers L

机构信息

Centro de Investigaciones en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.

出版信息

Rev Invest Clin. 1997 Mar-Apr;49(2):111-6.

PMID:9380963

Abstract

OBJECTIVE

To evaluate the diagnostic agreement in Papanicolaou of pathologists and cytotechnologists using kappa values for concordancy.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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。