Interobserver Agreement in Cytological Diagnosis of Atypical Squamous Cell, Cannot Exclude a High-Grade Lesion and High-Grade Squamous Intraepithelial Lesion in Cervical Lesions

• Autor(a) principal: Pergo, Leopoldo Silocchi
• Data de Publicação: 2022
• Outros Autores: Maffini, Cibele Feroldi, Zanine, Rita Maira, Collaço, Luiz Martins, Sebastião, Ana Paula Martins
• Tipo de documento: Artigo
• Idioma: por; eng
• Título da fonte: Revista Brasileira de Cancerologia (Online)
• Texto Completo: https://rbc.inca.gov.br/index.php/revista/article/view/1338
• topic: neoplasias do colo do útero; variações dependentes do observador; teste de Papanicolau; lesões intraepiteliais escamosas; uterine cervical neoplasms; observer variation; Papanicolaou test; squamous intraepithelial lesions; neoplasias del cuello uterino; variaciones dependientes del observador; prueba de Papanicolaou; lesiones intraepiteliales escamosas

Introduction: The Papanicolaou test is an important screening exam for cervical carcinoma. The cytological diagnosis of undetermined atypical squamous cells favoring high-grade lesion (ASC-H) is the category with the least interobserver concurrence. Objective: Evaluate the interobserver concurrence for the ASC-H and high-grade squamous intraepithelial lesions (HSIL) categories at a teaching hospital and to estimate ASC-H’s capacity to predict higher grade lesions. Method: Smears from patients admitted from 2007 to 2015 whose original diagnosis was made by one pathologist, in addition to colposcopy and biopsy, when indicated, made by one gynecologist were collected in the Pathologic Anatomy Service of the hospital. The cytology was reviewed by two other pathologists separately and blindly. Both reviewers had access to data about age at the moment of the diagnosis in order to reproduce the clinical diagnosis. Results: There were 65.1% smears considered as ASC-H and 34.9%, as HSIL. The reviews concurred simultaneously with the original diagnosis in 54.7% of the cases. The kappa indexes for both categories and only for ASC-H were, respectively, 0.46 and 0.49 (moderate concurrence). 68.3% of the smears primarily described as ASC-H resulted in higher grade lesions in histology. Conclusion: The data showed a moderate concurrence between the pathologists for the ASC-H’s diagnosis. It is important to highlight that ASC-H matched with higher grade lesions at the histology, needing follow-up as HSIL.