盆腔放疗对宫颈癌细胞学改变评价的可重复性有重要影响。

Q2 Medicine
BMC Clinical Pathology Pub Date : 2018-10-05 eCollection Date: 2018-01-01 DOI:10.1186/s12907-018-0078-z
Fernanda A Lucena, Ricardo F A Costa, Maira D Stein, Carlos E M C Andrade, Geórgia F Cintra, Marcelo A Vieira, Rozany M Dufloth, José Humberto T G Fregnani, Ricardo Dos Reis
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引用次数: 2

摘要

背景:根据患者是否接受放疗(RT)治疗的既往知识,评估宫颈细胞病理学在观察者内和观察者间的可重复性。方法:对95例宫颈细胞学切片进行分析;24例伴有细胞学异常(CA)和RT;21例无CA和RT存在;25例无CA,既往无RT;25例CA患者,既往无rt患者。对载玻片进行两次细胞病理学(CP)评估。对于第一次CP重新评估,细胞技术人员被盲法告知之前的rt信息。对于第二次CP重新评估,细胞技术人员被告知之前的rt。结果通过使用未加权和加权kappa通过观察者之间和内部的协议进行分析。结果:44.4%的既往盆腔放疗患者有放疗后疗效。放疗状态一致性为66.32%(未加权K = 0.31, 95%CI: 0.13;0.49,中度一致)。无论放射治疗状态如何,关于细胞学诊断的观察内一致性为80.32%(加权K = 0.52, 95%CI: 0.34;0.68)。在未接受放疗的组中,观察者内一致性为70%(加权K = 0.47, 95%CI: 0.27;0.65),在接受放疗的患者中,观察者内一致性为84.09%(未加权K = 0.37, 95%CI: 0.01;0.74)。考虑正常和异常CP诊断,RT组细胞病理学结果(异常或正常)的观察者间一致性分别为14.0%和12.5%。细胞学改变与RT结束和细胞学诊断之间的中位时间之间没有关联。结论:本研究表明,RT对CP的诊断有重要影响,因为在接受RT的患者中,在观察者之间和观察者内部的分析中,一致性有很大的差异。此外,当没有提供这些信息时,很难在细胞学切片中识别RT的存在。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Pelvic radiotherapy for cervical cancer affects importantly the reproducibility of cytological alterations evaluation.

Pelvic radiotherapy for cervical cancer affects importantly the reproducibility of cytological alterations evaluation.

Background: to evaluate the intraobserver and interobserver reproducibility of cervical cytopathology according to previous knowledge of whether patients received radiotherapy (RT) treatment or not.

Methods: The study analyzed a sample of 95 cervix cytological slides; 24 with cytological abnormalities (CA) and presence of RT; 21 without CA and presence of RT; 25 without CA and without previous RT; 25 with CA and without previous RT. Two cytopathology (CP) evaluations of the slides were carried out. For the first CP re-evaluation, the cytotechnologist was blinded for the information of previous RT. For the second CP re-evaluation, the cytotechnologist was informed about previous RT. The results were analyzed through inter and intraobserver agreement using the unweighted and weighted kappa.

Results: Post radiotherapy effects were identified in 44.4% of cases that undergone previous pelvic RT. The agreement for RT status was 66.32% (unweighted K = 0.31, 95%CI: 0.13; 0.49, moderate agreement). The intraobserver agreement, regarding the cytological diagnoses, regardless of radiotherapy status, was 80.32% (weighted K = 0.52, 95%CI: 0.34; 0.68). In no RT group, the intraobserver agreement was 70% (weighted K = 0.47, 95%CI: 0.27;0.65) and in patients that received RT, the intraobserver agreement was 84.09% (unweighted K = 0.37, 95%CI: 0.01;0.74). The interobserver agreement between cytopathology result (abnormal or normal) in the group with RT, considering normal and abnormal CP diagnosis was 14.0% and 12.5%, respectively. There was no association between the cytological alterations and the median time between the end of RT and the cytological diagnosis.

Conclusion: This study showed that RT has an important impact in CP diagnosis because the agreement, also in interobserver and intraobserver analysis, had high discrepancy in patients that received RT. Also, demonstrated that it is difficult to recognize the presence of RT in cytological slides when this information is not provided.

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来源期刊
BMC Clinical Pathology
BMC Clinical Pathology Medicine-Pathology and Forensic Medicine
CiteScore
3.30
自引率
0.00%
发文量
0
期刊介绍: BMC Clinical Pathology is an open access journal publishing original peer-reviewed research articles in all aspects of histopathology, haematology, clinical biochemistry, and medical microbiology (including virology, parasitology, and infection control). BMC Clinical Pathology (ISSN 1472-6890) is indexed/tracked/covered by PubMed, CAS, EMBASE, Scopus and Google Scholar.
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