Quality control in cervicovaginal cytology by cytohistological correlation

N. Izadi‐Mood, S. Sarmadi and S. Sanii 
Quality control in cervicovaginal cytology by cytohistological correlation Objective:  Frequent studies attest to the correlation of cytological interpretations with defined histopathological entities. Nevertheless, as part of quality control, cytology laborat...

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Published in:Cytopathology (Oxford) 2013-02, Vol.24 (1), p.33-38
Main Authors: Izadi-Mood, N., Sarmadi, S., Sanii, S.
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description N. Izadi‐Mood, S. Sarmadi and S. Sanii 
Quality control in cervicovaginal cytology by cytohistological correlation Objective:  Frequent studies attest to the correlation of cytological interpretations with defined histopathological entities. Nevertheless, as part of quality control, cytology laboratories are required to compare Papanicolaou smear reports with those of cervical biopsies to search for discrepancies. We have attempted to determine and categorize the causes of existing discrepancies in our laboratory in order to clarify the source of errors. Methods:  We reviewed 670 cervical smears that were paired with subsequent punch biopsy or endocervical curettage samples, obtained within 2 months of the cytology, and found out that 60 smear‐biopsy pairs were discrepant regarding the diagnosis. These cases were categorized into four error groups after careful re‐evaluation of the original smear and biopsy slides. Results:  In 51 (85%) of 60 cervical smear‐biopsy pairs with reports that disagreed, the initial diagnoses of both cervical smear and biopsy were confirmed by the review opinion; in these cases, cytology and biopsy ‘sampling errors’ were responsible for 40 and 11 instances of discrepancy, respectively. Seven cases (11.1%) were discrepant due to ‘smear interpretation errors’ and consisted of five cases with initial under‐diagnosis and two cases with initial over‐diagnosis. One case (1.7%) was due to ‘screener error’. In another case, discordance was due to cervical ‘biopsy interpretation error’, with initial over‐diagnosis as squamous intraepithelial lesion. Conclusion:  In this retrospective study, we determined the causes of cytohistological discrepancies in cervical samples. The main explanation for discrepancy was ‘sampling error’.
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Quality control in cervicovaginal cytology by cytohistological correlation Objective:  Frequent studies attest to the correlation of cytological interpretations with defined histopathological entities. Nevertheless, as part of quality control, cytology laboratories are required to compare Papanicolaou smear reports with those of cervical biopsies to search for discrepancies. We have attempted to determine and categorize the causes of existing discrepancies in our laboratory in order to clarify the source of errors. Methods:  We reviewed 670 cervical smears that were paired with subsequent punch biopsy or endocervical curettage samples, obtained within 2 months of the cytology, and found out that 60 smear‐biopsy pairs were discrepant regarding the diagnosis. These cases were categorized into four error groups after careful re‐evaluation of the original smear and biopsy slides. Results:  In 51 (85%) of 60 cervical smear‐biopsy pairs with reports that disagreed, the initial diagnoses of both cervical smear and biopsy were confirmed by the review opinion; in these cases, cytology and biopsy ‘sampling errors’ were responsible for 40 and 11 instances of discrepancy, respectively. Seven cases (11.1%) were discrepant due to ‘smear interpretation errors’ and consisted of five cases with initial under‐diagnosis and two cases with initial over‐diagnosis. One case (1.7%) was due to ‘screener error’. In another case, discordance was due to cervical ‘biopsy interpretation error’, with initial over‐diagnosis as squamous intraepithelial lesion. Conclusion:  In this retrospective study, we determined the causes of cytohistological discrepancies in cervical samples. The main explanation for discrepancy was ‘sampling error’.</description><identifier>ISSN: 0956-5507</identifier><identifier>EISSN: 1365-2303</identifier><identifier>DOI: 10.1111/j.1365-2303.2011.00926.x</identifier><identifier>PMID: 21929578</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>cervical biopsy ; Cervical Intraepithelial Neoplasia - diagnosis ; Cervix Uteri - pathology ; cytohistological correlation ; Early Detection of Cancer - methods ; Early Detection of Cancer - standards ; Female ; Humans ; interpretation error ; Neoplasm Grading - methods ; Neoplasms, Squamous Cell - diagnosis ; Observer Variation ; Pap smear ; Papanicolaou Test ; Quality Control ; Reproducibility of Results ; Retrospective Studies ; sampling error ; Sensitivity and Specificity ; squamous intraepithelial lesion ; Uterine Cervical Neoplasms - diagnosis ; Vaginal Smears - methods ; Vaginal Smears - standards</subject><ispartof>Cytopathology (Oxford), 2013-02, Vol.24 (1), p.33-38</ispartof><rights>2011 Blackwell Publishing Ltd</rights><rights>2011 Blackwell Publishing Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4066-4b921ae2159abe9133fd8d66923123e55bd5e88647fbe9970e2dc095e9b519c03</citedby><cites>FETCH-LOGICAL-c4066-4b921ae2159abe9133fd8d66923123e55bd5e88647fbe9970e2dc095e9b519c03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21929578$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Izadi-Mood, N.</creatorcontrib><creatorcontrib>Sarmadi, S.</creatorcontrib><creatorcontrib>Sanii, S.</creatorcontrib><title>Quality control in cervicovaginal cytology by cytohistological correlation</title><title>Cytopathology (Oxford)</title><addtitle>Cytopathology</addtitle><description>N. Izadi‐Mood, S. Sarmadi and S. Sanii 
Quality control in cervicovaginal cytology by cytohistological correlation Objective:  Frequent studies attest to the correlation of cytological interpretations with defined histopathological entities. Nevertheless, as part of quality control, cytology laboratories are required to compare Papanicolaou smear reports with those of cervical biopsies to search for discrepancies. We have attempted to determine and categorize the causes of existing discrepancies in our laboratory in order to clarify the source of errors. Methods:  We reviewed 670 cervical smears that were paired with subsequent punch biopsy or endocervical curettage samples, obtained within 2 months of the cytology, and found out that 60 smear‐biopsy pairs were discrepant regarding the diagnosis. These cases were categorized into four error groups after careful re‐evaluation of the original smear and biopsy slides. Results:  In 51 (85%) of 60 cervical smear‐biopsy pairs with reports that disagreed, the initial diagnoses of both cervical smear and biopsy were confirmed by the review opinion; in these cases, cytology and biopsy ‘sampling errors’ were responsible for 40 and 11 instances of discrepancy, respectively. Seven cases (11.1%) were discrepant due to ‘smear interpretation errors’ and consisted of five cases with initial under‐diagnosis and two cases with initial over‐diagnosis. One case (1.7%) was due to ‘screener error’. In another case, discordance was due to cervical ‘biopsy interpretation error’, with initial over‐diagnosis as squamous intraepithelial lesion. Conclusion:  In this retrospective study, we determined the causes of cytohistological discrepancies in cervical samples. 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Izadi‐Mood, S. Sarmadi and S. Sanii 
Quality control in cervicovaginal cytology by cytohistological correlation Objective:  Frequent studies attest to the correlation of cytological interpretations with defined histopathological entities. Nevertheless, as part of quality control, cytology laboratories are required to compare Papanicolaou smear reports with those of cervical biopsies to search for discrepancies. We have attempted to determine and categorize the causes of existing discrepancies in our laboratory in order to clarify the source of errors. Methods:  We reviewed 670 cervical smears that were paired with subsequent punch biopsy or endocervical curettage samples, obtained within 2 months of the cytology, and found out that 60 smear‐biopsy pairs were discrepant regarding the diagnosis. These cases were categorized into four error groups after careful re‐evaluation of the original smear and biopsy slides. Results:  In 51 (85%) of 60 cervical smear‐biopsy pairs with reports that disagreed, the initial diagnoses of both cervical smear and biopsy were confirmed by the review opinion; in these cases, cytology and biopsy ‘sampling errors’ were responsible for 40 and 11 instances of discrepancy, respectively. Seven cases (11.1%) were discrepant due to ‘smear interpretation errors’ and consisted of five cases with initial under‐diagnosis and two cases with initial over‐diagnosis. One case (1.7%) was due to ‘screener error’. In another case, discordance was due to cervical ‘biopsy interpretation error’, with initial over‐diagnosis as squamous intraepithelial lesion. Conclusion:  In this retrospective study, we determined the causes of cytohistological discrepancies in cervical samples. The main explanation for discrepancy was ‘sampling error’.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21929578</pmid><doi>10.1111/j.1365-2303.2011.00926.x</doi><tpages>6</tpages></addata></record>
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subjects cervical biopsy
Cervical Intraepithelial Neoplasia - diagnosis
Cervix Uteri - pathology
cytohistological correlation
Early Detection of Cancer - methods
Early Detection of Cancer - standards
Female
Humans
interpretation error
Neoplasm Grading - methods
Neoplasms, Squamous Cell - diagnosis
Observer Variation
Pap smear
Papanicolaou Test
Quality Control
Reproducibility of Results
Retrospective Studies
sampling error
Sensitivity and Specificity
squamous intraepithelial lesion
Uterine Cervical Neoplasms - diagnosis
Vaginal Smears - methods
Vaginal Smears - standards
title Quality control in cervicovaginal cytology by cytohistological correlation
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