Inter observer variability in the interpretation of atypical squamous cells in Pap smear examination
Journal Title: Perspectives In Medical Research - Year 2019, Vol 7, Issue 1
Abstract
Introduction: The incidence of cervical cancer has decreased due to wide spread use of Papanicolaou test (Pap) as a screening method to detect early cervical lesions. According to The Bethesda System 2001, atypical squamous cells are divided into two groups: Atypical squamous cells of undetermined significance (ASC-US), atypical squamous cells cannot exclude HSIL (ASC-H). As it is known, the microscopic interpretation of cytologic specimens is a subjective procedure highly dependent on skills and experience of the investigator. ASC reflects a diagnosis of uncertainty and is used as tool to measure interlaboratory and intralaboratory control for quality control purposes. Aims and Objectives: To determine the inter observer variation in interpreting ASC variants in conventional pap smears based on the Bethesda system of reporting cervical cytology (2001). Materials and Methods :A total of 833 cervical smears were sent for Pap test during the period July 2013 to –June 2014. Slides of all the cases of ASC and appropriate number of smears diagnosed as negative for intraepithelial lesion or malignancy were collected with relevant history. An observational study was performed with two evaluators blinded to the original reports. The review reports from the evaluators were compared with original reports to detect accuracy of reporting atypical squamous cells. Results:Review of data showed 36 low-grade squamous intraepithelial lesion (LSIL), 8 high-grade squamous intraepithelial lesion (HSIL) and 17 cases coded as atypical squamous cells (ASCUS and ASC-H). ASCUS/SIL ratio was 0.33. All the agreements were found out to be statistically significant and the agreement between original diagnosis and observer 1 was found out to be stronger compared to others. Conclusion: Interobserver reproducibility in reporting cervical smears according to Bethesda system 2001 is not 100%, even after following strict Bethesda guidelines. Rescreening of smears is one of the best ways to improve quality control of the cytopathology laboratory.
Authors and Affiliations
Deepthi V S
Keywords
Related Articles
- EP ID EP391472
- DOI -
- Views 154
- Downloads 0
Transmural migration of Gossypiboma presenting as Intestinal obstruction
Introduction: Gossypiboma or retained surgical sponge is rare but serious complication of surgery. It is a surgeon’s nightmare with medicolegalcomplications.It amounts to medical negligence of the surgical team.Diagnosis...
Prevalence and risk factors of depression among elderly population in a rural area
Background: The community-based mental health studies in India have estimated the prevalence of depressive disorders among elderly population between 13% and 25%. Despite of the widespread belief that depression in elder...
Cytological diagnosis of Malignant melanoma of left foot
Introduction: Malignant Melanoma is an uncommon case in cytology and it can mimic mesenchymal lesions if spindle cell component predominates. The differential diagnosis can be narrowed in its favor if proper protocol of...
Neurological manifestations in peripartum period
Introduction: Several neurological diseases are unique to pregnancy and postpartum period . Some disorders increase in prevalence during this period. Objective :To study the clinical profile of patients presenting with...
Malignant mixed mullerian tumor of uterus - An unusual presentation
Introduction: Malignant Mixed Mullerian Tumor (MMMT), also called as carcinosarcoma, is an aggressive rare variant of uterine malignancy. MMMT is commonly associated with post-menopausal, nulliparous females with hyperes...