Validation of full-remote reporting for cervicovaginal cytology: the Caltagirone-Acireale distributed lab.

Autor: Caputo A; Department of Pathology, University Hospital 'San Giovanni di Dio e Ruggi D'Aragona', Salerno, Italy; Department of Pathology, Hospital 'Gravina e Santo Pietro', Caltagirone, Italy., Macrì L; Central Cervicovaginal Screening Unit and Center for Cancer Epidemiology and Prevention, Turin, Italy., Gibilisco F; Department of Pathology, Hospital 'Gravina e Santo Pietro', Caltagirone, Italy; Department of Medical and Surgical Sciences and Advanced Technologies, 'G. F. Ingrassia', University of Catania, Catania, Italy., Vatrano S; Department of Pathology, Hospital 'Gravina e Santo Pietro', Caltagirone, Italy., Taranto C; Department of Pathology, Hospital 'Gravina e Santo Pietro', Caltagirone, Italy., Occhipinti E; Department of Pathology, Hospital 'Gravina e Santo Pietro', Caltagirone, Italy., Santamaria F; Department of Pathology, Hospital 'Gravina e Santo Pietro', Caltagirone, Italy., Arcoria A; Department of Pathology, Hospital 'Gravina e Santo Pietro', Caltagirone, Italy., Scillieri R; Dipartimento di Prevenzione, ASP Catania, Catania, Italy., Fraggetta F; Department of Pathology, Hospital 'Gravina e Santo Pietro', Caltagirone, Italy. Electronic address: filippofra@hotmail.com.
Jazyk: angličtina
Zdroj: Journal of the American Society of Cytopathology [J Am Soc Cytopathol] 2023 Sep-Oct; Vol. 12 (5), pp. 378-385. Date of Electronic Publication: 2023 Jun 07.
DOI: 10.1016/j.jasc.2023.06.001
Abstrakt: Introduction: Cervical cancer is the fourth most common cancer in women, and its prevention is based on vaccination and screening. Screening consists of molecular human papillomavirus (HPV) testing and cytologic analysis of cervical smears, which require expensive equipment and the interaction of numerous professionals such as biologists, cytologists, laboratory technicians, and pathologists.
Materials and Methods: We centralize the cervical samples from more than 51 clinics in 1 main laboratory, where automated HPV testing is performed. HPV-positive cases are collected and used to prepare a liquid-based cytology slide, which is stained and immediately scanned. The resulting whole-slide images (WSIs) are immediately available in a remote laboratory where they are examined by experienced cytologists using virtual microscopy. This setup was validated by making each of the 3 readers independently diagnose 506 specimens in random order, using both conventional light microscopy (CLM) and WSIs, with a minimum wash-out period of 3 weeks and with a final discussion for all cases.
Results: Intraobserver agreement among CLM and WSI ranged from 0.71 to 0.79, and interobserver agreement for the 3 readers compared with the consensus diagnosis was similar for the 2 modes of assessment. Readers subjectively felt confident in their WSI diagnosis for inadequate and negative cases, but less so in other cases. The perceived difficulty was slightly higher in WSI readings.
Conclusions: Interobserver agreement in cervicovaginal cytology is moderate and does not vary if the slides are examined conventionally or digitally. Despite higher reported subjective difficulty and lower confidence in the WSI diagnosis, we did not observe a deterioration in diagnostic performance using WSI compared with CLM.
(Copyright © 2023 American Society of Cytopathology. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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