Interlaboratory reproducibility of atypical squamous cells of undetermined significance report: a national survey

Confortini, Massimo; Carozzi, Francesca; Palma, Paolo Dalla; Ghiringhello, Bruno; Parisio, F.; Prandi, Sonia; Ronco, Guglielmo; Ciatto, Stefano; Montanari, G

doi:10.1046/j.1365-2303.2003.00061.x

Cited by 31 publications

(20 citation statements)

References 16 publications

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“…The decision to refer all patients with minor cytologic abnormalities for colposcopy implies a large number of unnecessary colposcopies and colposcopy-directed biopsy and has a negative impact on screening costs. Moreover, as confirmed recently in a large Italian study, 2 the reproducibility of ASCUS reports is quite low, and the action prompted by an ASCUS report would be decided on a local basis and should be based on the observed PPV for Ͼ CIN2 lesions. 3 Criteria to qualify ASCUS 4 findings (Bethesda System, 2001; ASC-US and atypical squamous cells-cannot exclude HSIL [ASC-H]) have been proposed to improve the specificity of referral to colposcopy while keeping a high sensitivity level.…”

mentioning

confidence: 97%

Triage with human papillomavirus testing of women with cytologic abnormalities prompting referral for colposcopy assessment

Carozzi

Confortini

Cecchini

et al. 2004

Cancer

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Spoiled gradient echo sequences can only reach a homogeneous steady state if sufficiently strong crusher gradients are used in combination with RF phase cycling (RF spoiling). However, the signal depends quite sensitively on the chosen phase increment ϕ and—lacking analytical solutions—numerical simulations must be used to study the transient and steady‐state magnetization. For the steady state an exact analytical solution is derived, which holds for arbitrary sequence and tissue parameters. Besides a considerably improved computation performance, the analytical approach enables a better understanding of the complicated dependence on ϕ. For short repetition times (TR) the regime of small ϕ turns out to be particularly interesting: It is shown that the typical ϕc, where RF spoiling starts to become effective, is essentially inversely proportional to T2. This tissue dependence implies that contrasts can be considerably larger with partial spoiling (ϕ ≈ ϕc) than with conventional RF spoiling (ϕ ≫ ϕc). As an example, the uptake of contrast agents in tissues is investigated. For typical parameters a considerably improved contrast enhancement can be obtained, both theoretically and experimentally. Magn Reson Med, 2006. © 2005 Wiley‐Liss, Inc.

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mentioning

confidence: 97%

Triage with human papillomavirus testing of women with cytologic abnormalities prompting referral for colposcopy assessment

Carozzi

Confortini

Cecchini

et al. 2004

Cancer

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“…This interlaboratory and interobserver variability has been found in other studies. Confortini et al [23] showed a low interlaboratory reproducibility in the category ASC-US (kappa = 0.34). Gatscha et al [24] showed in their review that, out of 632 smears first diagnosed with atypical squamous, only 200 cases (32%) showed interobserver agreement, which demonstrated the low reproducibility of this diagnostic category.…”

Section: Discussionmentioning

confidence: 99%

External Quality Control of Cervical Cytopathology: Interlaboratory Variability

Ázara¹,

Manrique²,

Souza³

et al. 2013

Acta Cytologica

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Objective: To compare the variability of screening tests held at laboratories with the Unit for External Quality Control (UEQC), checking the frequency of cases that were discordant, false-positive, false-negative, unsatisfactory or that had a delay in clinical management and diagnostic agreement. Materials and Methods: The study analyzed 10,053 screening tests from January 2007 to December 2008, including all positive cases, all those that fall under unsatisfactory and at least 10% of negative screening tests. The magnitude of the agreement was analyzed using the kappa coefficient. Results: Out of the 10,053 cases analyzed, 7.59% were considered disagreeing, and it was estimated that 1.1% were false-negative. There was a delay in the clinical procedure regarding 2.44% cases. There were 2.82% of cases identified as false-positive and 1.24% as unsatisfactory. The diagnostic agreement was excellent (kappa = 0.81). The agreement of most laboratories concerning screening tests was classified as very good. The agreement of the sample adequacy was reasonable (kappa = 0.30) and the agreement regarding the representation of epithelia was considered excellent. Conclusion: Most laboratories showed very good agreement; however, it is worthy of note that to establish the standardization of diagnostic criteria, and enhance the accuracy of screening and improve the quality of cytopathology test results, it is necessary to perform external quality control.

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“…Ha sido claramente documentado que las células escamosas atípicas de significado indeterminado es la interpretación menos reproducible de todas las categorías del sistema Bethesda (19,20). Por lo tanto, estas diferencias pueden reflejar dificultades en la implementación de criterios para la lectura de las citologías con esta categoría y sugiere la necesidad de un sistema que evalúe la reproducibilidad de los resultados de células escamosas atípicas de significado indeterminado en la citología en nuestro medio.…”

Section: Discussionunclassified

Prevalencia de anormalidades de células epiteliales y factores asociados en mujeres de un municipio rural colombiano

et al. 2008

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Introducción. A pesar de la existencia de los programas de tamización basados en la citología, las tasas de cáncer de cuello uterino permanecen estables en Colombia. La descripción de los factores asociados a las lesiones precursoras de cáncer de cuello uterino es necesaria para establecer estrategias para su prevención. Objetivo. Determinar la prevalencia de las anormalidades de células epiteliales escamosas y su asociación con los factores de riesgo descritos. Materiales y métodos. Estudio transversal de población en 739 mujeres, seleccionadas en forma aleatoria. La información se recolectó mediante la citología y un cuestionario previamente validado. La medida de asociación fue la razón de prevalencia con su respectivo intervalo de confianza del 95%. Las variables de confusión fueron controladas en un modelo de regresión logística multivariado. Resultados. La prevalencia del evento fue de 15,8%. Entre las mujeres con citología anormal, 10% presentó células escamosas atípicas de significado indeterminado; 3,9%, lesión escamosa intraepitelial de bajo grado, y 1,9%, lesión escamosa intraepitelial de alto grado. La regresión logística ajustada sugiere que los antecedentes de enfermedades de transmisión sexual, una citología anormal y tener dos o más parejas regulares/ocasionales durante la vida se asocian con la presencia del evento. Conclusiones. La relación de anormalidades de células escamosas con conducta sexual refleja la asociación entre el virus del papiloma humano y lesiones preneoplásicas de cáncer de cuello uterino. El uso frecuente y el adecuado conocimiento sobre la citología, sugiere que aspectos tales como las dificultades con la calidad de la citología o el acceso al diagnóstico y tratamiento, pudieran explicar las altas tasas de cáncer de cuello uterino.Palabras clave: neoplasias del cuello uterino/epidemiología, células epiteliales, frotis vaginal, citología, neoplasia intraepitelial del cuello uterino/prevención y control, Colombia. Prevalence of epithelial squamous cell abnormalities and associated factors in women of a rural town of ColombiaIntroduction. In spite of implementation of cytology-based cervical cancer screening in Colombia, mortality rates remain stable. The description of factors associated to cervical preneoplasic lesions is needed to establish strategies for mortality prevention. Objective. The prevalence of epithelial squamous cell abnormalities was determined to explore the association of cytology abnormalities with described risk factors. Materials and methods.This population-based, cross-sectional study included 739 women randomly selected by age. A validated face-to-face questionnaire and conventional cervical cytology were used to collect the information. To establish the association between cervical abnormalities and some qualitative variables, the independent chi squared test was used. We also calculated prevalence ratio with their 95% confidence intervals. A logistic regression model was used to explore variables that potentially explain cytology abnormalities. Result...

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Interlaboratory reproducibility of atypical squamous cells of undetermined significance report: a national survey

Cited by 31 publications

References 16 publications

Triage with human papillomavirus testing of women with cytologic abnormalities prompting referral for colposcopy assessment

Triage with human papillomavirus testing of women with cytologic abnormalities prompting referral for colposcopy assessment

External Quality Control of Cervical Cytopathology: Interlaboratory Variability

Prevalencia de anormalidades de células epiteliales y factores asociados en mujeres de un municipio rural colombiano

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