| Discrepancy in the interpretation of cervical histology by gynecologic pathologists. | |
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MedLine Citation:
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PMID: 12151150 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Mary F Parker; Christopher M Zahn; Kristina M Vogel; Cara H Olsen; Kunio Miyazawa; Dennis M O'Connor |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 100 ISSN: 0029-7844 ISO Abbreviation: Obstet Gynecol Publication Date: 2002 Aug |
Date Detail:
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Created Date: 2002-08-01 Completed Date: 2002-08-22 Revised Date: 2009-10-26 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 277-80 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynecology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA. parker@tatrc.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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