Document Detail


The Bethesda System. Impact on reporting cervicovaginal specimens and reproducibility of criteria for assessing endocervical sampling.
MedLine Citation:
PMID:  8434497     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study examined the impact of applying the Bethesda System guidelines for specimen adequacy on cytopathologic diagnosis at the Johns Hopkins Hospital laboratory of cytopathology during a one-year period. Application of the Bethesda guidelines resulted in a 1.3% unsatisfactory rate. In addition, 3.8% of specimens were satisfactory but contained an inadequate endocervical component (IEC). Smears obtained after a cone biopsy or an initial IEC smear were IEC in 16.5% and 18.7% of cases, respectively. The IEC rate following an initial smear lacking an endocervical component was 11.8% in repeat specimens obtained with an endocervical brush as compared to 29.4% in those obtained with a spatula alone. The reproducibility of the Bethesda criteria for assessing endocervical sampling was evaluated by comparing the level of agreement between three independent reviewers examining 40 test cases. Three-way agreement was achieved in 75% of cases. Two-way agreement ranged from 80.0% to 87.5%. We conclude that implementation of the Bethesda System guidelines for assessing specimen adequacy should produce a minimal impact on cytopathologic reporting and gynecologic practice. Repeat specimens lacking an endocervical component may be encountered relatively frequently in certain subsets of patients.
Authors:
M E Sherman; M Weinstein; M Sughayer; J O Cappellari; J E Orr; Y S Erozan; M H Schiffman; R J Kurman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta cytologica     Volume:  37     ISSN:  0001-5547     ISO Abbreviation:  Acta Cytol.     Publication Date:    1993 Jan-Feb
Date Detail:
Created Date:  1993-03-17     Completed Date:  1993-03-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370307     Medline TA:  Acta Cytol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  55-60     Citation Subset:  IM    
Affiliation:
Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Biopsy
Cervix Uteri / pathology*
Evaluation Studies as Topic
Female
Humans
Middle Aged
Practice Guidelines as Topic*
Vaginal Smears*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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