Papanicolaou tests diagnosed as atypical by a cytotechnologist and downgraded to benign by a pathologist: a measure of laboratory quality
| Autor: | Stephen S. Raab, Jennifer L. Condel, Charles D. Sturgis, Laura K. Mahood, Dana Marie Grzybicki |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Quality Control
Pathology medicine.medical_specialty Papanicolaou stain Uterine Cervical Neoplasms Atypical Squamous Cells Cervix Uteri Abnormal PAP Smear Medical Laboratory Personnel Medicine Humans Pap test Observer Variation Vaginal Smears medicine.diagnostic_test business.industry fungi General Medicine Cell Biology medicine.disease Uterine Cervical Dysplasia Squamous intraepithelial lesion Cytopathology Female business Premalignant lesion Ascus Papanicolaou Test |
| Zdroj: | American journal of clinical pathology. 117(4) |
| ISSN: | 0002-9173 |
| Popis: | Follow-up of Papanicolaou (Pap) tests diagnosed as atypical squamous cells of undetermined significance (ASCUS) or atypical glandular cells of undetermined significance (AGUS) by a cytotechnologist and downgraded to benign by a pathologist has not been measured. Squamous intraepithelial lesion (SIL) follow-up rates were obtained for Pap tests diagnosed as ASCUS (288) or AGUS (94) and downgraded to benign and for Pap tests diagnosed as repair (231). Statistically significant associations were seen between 7 cytotechnologists and between 7 pathologists and ASCUS, AGUS, downgraded ASCUS, and downgraded AGUS rates. The percentage of downgraded ASCUS cases compared with all ASCUS cases per pathologist ranged from 4.8% to 43.7%. Statistically significant associations between pathologists and SIL follow-up rates for downgraded ASCUS diagnoses were seen. The SIL follow-up rate for repair (7.9%) was similar to that for a downgraded ASCUS (11.0%) or AGUS (7.3%). The parameters of downgraded ASCUS and AGUS Pap test interpretations are good quality indicators of individual performance and overall laboratory quality. American governmental regulations require that a Papanicolaou (Pap) test screened and diagnosed as atypical squamous cells of undetermined significance (ASCUS) or atypical glandular cells of undetermined significance (AGUS) by a cytotechnologist must be reviewed by a pathologist. 1 Because ASCUS is the most common diagnosis of epithelial cell abnormalities, 2 the frequency of referral of an ASCUS diagnosis by cytotechnologists strongly affects the frequency of overall laboratory rates of diagnoses given as “atypical.” However, the referral rates of cytotechnologists for such atypical diagnoses rarely have been analyzed in the literature. 3-6 |
| Databáze: | OpenAIRE |
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