[Diagnostic concordance in gynecologic cytology]

Rev Invest Clin. 1997 Mar-Apr;49(2):111-6.
[Article in Spanish]

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.

Publication types

  • Comparative Study
  • English Abstract

MeSH terms

  • Carcinoma / diagnosis
  • Carcinoma / pathology
  • Cell Nucleus / ultrastructure
  • Cervix Uteri / cytology
  • Female
  • Humans
  • Mexico
  • Observer Variation
  • Papanicolaou Test*
  • Reproducibility of Results
  • Uterine Cervical Diseases / classification
  • Uterine Cervical Diseases / diagnosis*
  • Uterine Cervical Diseases / pathology
  • Uterine Cervical Dysplasia / diagnosis
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / pathology
  • Vaginal Smears* / standards
  • Vaginal Smears* / statistics & numerical data