Cervical cytology and histology correlation as an analytic quality assurance exercise: Experience from an accredited cytology laboratory

IF 1 4区医学 Q4 MEDICAL LABORATORY TECHNOLOGY

Journal of Cytology Pub Date : 2023-01-01 DOI:10.4103/joc.joc_174_22

ShubhangiV Belekar, Meherbano Kamal, AishwaryaS Warke

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引用次数: 0

Abstract

Context: The performance parameters of cervical cytology in any accredited cytology laboratory requires implementation of quality control exercise, which ensures acceptable performance by a laboratory. This study aims to assess the analytical aspect of quality control measures by evaluating the frequency and accuracy of epithelial abnormalities as detected in cervical Pap smears using histopathologic diagnosis as the gold standard. Methods: A retrospective diagnostic test study from 2018 to 2020 was conducted. Out of the total 6000 Pap smears, histopathologic correlation was available in 150 cases in the form of colposcopic-directed biopsy (CDB) and loop electrosurgical excision procedure (LEEP) tissue in 105 cases. The quality control measures analyzed were Atypical Squamous Cell: Squamous Intraepithelial Lesion (ASC: SIL) ratio, cyto-histo correlation, and study parameters like sensitivity, specificity, positive predictive value, and negative predictive value of Pap smears as against CDB and LEEP. Results: 4.5% smears were reported as inadequate, 92.3% as Negative for intraepithelial lesion or malignancy (NILM), followed by epithelial abnormality found in 3.21%. The ASC: SIL ratio was 1.3:1. Concordance rate against CDB was 100% in Squamous cell carcinoma (SCC), 82.35% in high-grade squamous intraepithelial lesion (HSIL), 82% in atypical squamous cells of undetermined significance (ASCUS), 65.6% in low-grade squamous intraepithelial lesion (LSIL), and 50% in Atypical Squamous Cell ,High grade Squamous Intraepithelial Lesion can not be ruled out (ASC-H). Total concordance rate was 84.15%. Sensitivity of Pap smear was 65% for LSIL and 82% for HSIL. Specificity, positive predictive value, and negative predictive value were 63.63%, 90%, and 75%, respectively. Concordance rate was 96% with LEEP. Conclusion: Quality control measures give an insight of performance of any accredited cytology laboratory. This exercise needs to be conducted on a regular basis, so that relevant steps can be taken in case of major discrepancy.

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宫颈细胞学和组织学相关性作为分析质量保证练习:来自认可细胞学实验室的经验

背景:任何认可的细胞学实验室的宫颈细胞学性能参数要求实施质量控制活动，以确保实验室的可接受性能。本研究旨在评估质量控制措施的分析方面，通过评估宫颈涂片检测上皮异常的频率和准确性，以组织病理学诊断为金标准。方法:2018 ~ 2020年进行回顾性诊断试验研究。在总共6000例巴氏涂片检查中，150例以阴道镜指导活检(CDB)和105例环电手术切除(LEEP)组织的形式存在组织病理学相关性。分析的质量控制措施包括非典型鳞状细胞:鳞状上皮内病变(ASC: SIL)比率、细胞与组织的相关性，以及巴氏涂片对CDB和LEEP的敏感性、特异性、阳性预测值和阴性预测值等研究参数。结果:涂片不充分者占4.5%，上皮内病变或恶性(NILM)阴性者占92.3%，上皮异常者占3.21%。ASC: SIL比值为1.3:1。鳞状细胞癌(SCC)对CDB的符合率为100%，高级别鳞状上皮内病变(HSIL)为82.35%，不确定意义的非典型鳞状细胞(ASCUS)为82%，低级别鳞状上皮内病变(LSIL)为65.6%，非典型鳞状细胞为50%，高级别鳞状上皮内病变不能排除(ASC-H)。总符合率为84.15%。巴氏涂片检测LSIL的敏感性为65%，HSIL的敏感性为82%。特异性为63.63%，阳性预测值为90%，阴性预测值为75%。LEEP的符合率为96%。结论:质量控制措施提供了任何认可细胞学实验室的性能洞察力。这项工作需要定期进行，以便在出现重大差异时采取有关步骤。

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来源期刊

Journal of Cytology MEDICAL LABORATORY TECHNOLOGY-

CiteScore

1.80

自引率

7.70%

发文量

审稿时长

46 weeks

期刊介绍： The Journal of Cytology is the official Quarterly publication of the Indian Academy of Cytologists. It is in the 25th year of publication in the year 2008. The journal covers all aspects of diagnostic cytology, including fine needle aspiration cytology, gynecological and non-gynecological cytology. Articles on ancillary techniques, like cytochemistry, immunocytochemistry, electron microscopy, molecular cytopathology, as applied to cytological material are also welcome. The journal gives preference to clinically oriented studies over experimental and animal studies. The Journal would publish peer-reviewed original research papers, case reports, systematic reviews, meta-analysis, and debates.