Evaluation of the training program for p16/ Ki-67 dual immunocytochemical staining interpretation for laboratory staff without experience in cervical cytology and immunocytochemistry

Autor: Nika Kotnik, Veronika Kloboves Prevodnik, Urška Ivanuš, Ziva Pohar Marinsek, Tine Jerman, Jerneja Varl, Hermina Rozina, Janja Zalar
Rok vydání: 2020
Předmět:
Adult
0301 basic medicine
medicine.medical_specialty
Time Factors
Inter observer reproducibility
Slovenia
education
R895-920
Uterine Cervical Neoplasms
Sensitivity and Specificity
Immunocytochemical staining
Medical physics. Medical radiology. Nuclear medicine
03 medical and health sciences
0302 clinical medicine
Medical Laboratory Personnel
Humans
Medicine
Radiology
Nuclear Medicine and imaging

Medical physics
Cyclin-Dependent Kinase Inhibitor p16
Observer Variation
Vaginal Smears
Protocol (science)
p16/ki-67 dual immunocytochemical staining
Staining and Labeling
accuracy
business.industry
Significant difference
Cervical cytology
Middle Aged
Uterine Cervical Dysplasia
Immunohistochemistry
Ki-67 Antigen
030104 developmental biology
Initial training
Oncology
030220 oncology & carcinogenesis
inter-observer reproducibility
Female
business
Training program
agreement
training protocol
Kappa
Research Article
Program Evaluation
Zdroj: Radiology and Oncology, Vol 54, Iss 2, Pp 201-208 (2020)
Radiology and Oncology
ISSN: 1581-3207
DOI: 10.2478/raon-2020-0018
Popis: Background p16/Ki-67 dual immunocytochemical staining (DS) is considered easy to interpret if evaluators are properly trained, however, there is no consensus on what constitutes proper training. In the present study we evaluated a protocol for teaching DS evaluation on students inexperienced in cervical cytology. Methods Initial training on 40 DS conventional smears was provided by a senior cytotechnologist experienced in such evaluation. Afterwards, two students evaluated 118 cases. Additional training consisted mainly of discussing discrepant cases from the first evaluation and was followed by evaluation of new 383 cases. Agreement and accuracy of students’ results were compared among the participants and to the results of the reference after both evaluations. We also noted time needed for evaluation of one slide as well as intra-observer variability of the teacher’s results. Results At the end of the study, agreement between students and reference was higher compared to those after initial training (overall percent agreement [OPA] 81.4% for each student, kappa 0.512 and 0.527 vs. OPA 78.3% and 87.2%, kappa 0.556 and 0.713, respectively). However, accuracy results differed between the two students. After initial training sensitivity was 4.3% points and 2.9% points higher, respectively compared to the reference, while specificity was 30.6% points and 24.4% points lower, respectively, compared to the reference. At the end of the study, the sensitivity reached by one student was the same as that of the reference, while it was 2.6% points lower for the other student. There was a statistically significant difference in specificity between one student and the reference and also between students (16.7 and 15.1% points). Towards the end of the study, one student needed 5.2 min for evaluating one slide while the other needed 8.2 min. The intra-observer variability of the senior cytotechnologist was in the range of “very good” in both arms of the study. Conclusions In teaching DS evaluation, the students’ progress has to be monitored using several criteria like agreement, accuracy and time needed for evaluating one slide. The monitoring process has to continue for a while after students reach satisfactory results in order to assure a continuous good performance. Monitoring of teacher’s performance is also advisable.
Databáze: OpenAIRE