Document Detail


Discrepancy in the interpretation of cervical histology by gynecologic pathologists.
MedLine Citation:
PMID:  12151150     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine if subspecialty review of cervical histology improves diagnostic consensus of cervical intraepithelial neoplasia (CIN). METHODS: After routine histologic assessment within the hospital pathology department, 119 colposcopic cervical biopsies were interpreted by two subspecialty-trained gynecologic pathologists (GYN I and GYN II) blinded to each other's interpretations and to the interpretations of the hospital general pathologists (GEN). Biopsies were classified as normal (including cervicitis), low grade (LG, including CIN I and human papillomavirus changes), and high grade (HG, including CIN II/III). The interobserver agreement rates between GEN and GYN I, between GEN and GYN II, and between GYN I and GYN II were described using the kappa statistic. The proportions of biopsies assigned to each biopsy class were compared using McNemar test. RESULTS: Interobserver agreement rates between GEN and GYN I were moderate for normal (kappa = 0.53) and LG (kappa = 0.46) and excellent for HG (kappa = 0.76). There were no significant differences in the classifications between GEN and GYN I. Interobserver agreement rates between GEN and GYN II were moderate for normal (kappa = 0.50) and LG (kappa = 0.44) and excellent for HG (kappa = 0.84). Also, GYN II was significantly more likely to classify biopsies as normal (P <.001) and less likely to classify biopsies as LG (P <.001). The interobserver agreement rates between GYN I and GYN II were moderate for normal (kappa = 0.61) and LG (kappa = 0.41) and excellent for HG (kappa = 0.84). Also, GYN II was significantly more likely to classify biopsies as normal (P <.001) and less likely to classify biopsies as LG (P =.01). CONCLUSION: Interobserver agreement between two gynecologic pathologists was no better than that observed between general and gynecologic pathologists. Subspecialty review of cervical histology does not enhance diagnostic consensus of CIN.
Authors:
Mary F Parker; Christopher M Zahn; Kristina M Vogel; Cara H Olsen; Kunio Miyazawa; Dennis M O'Connor
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  100     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-01     Completed Date:  2002-08-22     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  277-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA. parker@tatrc.org
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MeSH Terms
Descriptor/Qualifier:
Biopsy, Needle
Cervical Intraepithelial Neoplasia / pathology*
Clinical Competence*
Colposcopy
Culture Techniques
Female
Gynecology / standards
Humans
Immunohistochemistry
Observer Variation
Pathology, Clinical / standards*
Probability
Sensitivity and Specificity
Uterine Cervical Neoplasms / pathology*

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


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