Rt. Grenko et al., Variance in the interpretation of cervical biopsy specimens obtained for atypical squamous cells of undetermined significance, AM J CLIN P, 114(5), 2000, pp. 735-740
Citations number
22
Categorie Soggetti
Research/Laboratory Medicine & Medical Tecnology","Medical Research Diagnosis & Treatment
We sought to determine whether the variability in dysplasia rates in cases
of atypical squamous cells of undetermined significance (ASCUS) reflects va
riability in interpretation of cervical biopsy specimens. In phase 1, 124 b
iopsy specimens obtained because of a cytologic diagnosis of ASCUS were rev
iewed independently by 5 experienced pathologists. Diagnostic choices were
normal, squamous metaplasia, reactive, indeterminate, low-grade squamous in
traepithelial lesion (LSIL), and high-grade squamous intraepithelial lesion
(HSIL). The rate of dysplasia ranged from 23% to 51%. All pathologists agr
eed in 28% of cases. In 52% of cases, the diagnoses ranged from benign to d
ysplasia. The overall interobserver agreement was pool: In phase 2, 60 cerv
ical biopsy specimens (21 obtained for ASCUS, 22 for LSIL, and 17 for HSIL)
were evaluated using the same diagnostic choices. Agreement was better in
biopsies performed for HSIL and LSIL compared to those for ASCUS. Intraobse
rver reproducibility in the interpretation of biopsies performed for ASCUS
ranged fr om poor to excellent We conclude that variability in the interpre
tation of biopsy specimens plays an important role in the differences in ra
tes of dysplasia reported for the follow-up of ASCUS.