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Published on: July 25, 2017
[Diagnostic concordance in gynecologic cytology]
E C Lazcano Ponce1, P A de Ruiz, C Martínez Arias
1Centro de Investigaciones en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
Objective:
To evaluate the diagnostic agreement in Papanicolaou of pathologists and cytotechnologists using kappa values for concordancy.
Methods:
The diagnostic variation was estimated in 20 gynecological cytology (Pap) specimens by 30 pathologists and 7 cytotechnologists attending the XXXVII Congress of the Mexican Association of Pathologists in 1994.
Results:
The best concordancy versus an expert was in tumoral diathesis (pathologists' kappa = 0.36; cytotechnologists' kappa = 0.35) and kollocytos (pathologists' kappa = 0.55; cytotechnologists' kappa = 0.36). The least concordancy was observed in anisonucleosis (pathologists' kappa = 0.11; cytotechnologists' kappa = 0.02), nuclear hyperchromasia (pathologists' and cytotechnologists' kappa = 0.11) and dyskeratosis (pathologists' kappa = 0.11; cytotechnologists' kappa = 0.16). The kappa values for cervical neoplasia showed poor agreement, and in invasive cervical cancer it was 0.30.
Conclusions:
There was a low concordancy of Pap diagnosis in the study. It is convenient to try to improve the concordancy of cytologic diagnosis in Mexico. One strategy could be the use of a uniform diagnostic criteria and the adoption of a single nomenclature.
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