Interobserver variability and accuracy of p16/Ki-67 dual immunocytochemical staining on conventional cervical smears
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Le résumé fourni par la source
BACKGROUND: p16/Ki-67 dual immunocytochemical staining (DS) has been proven as a sensitive and specific test for triage of HPV positive women with good reproducibility and accuracy. However, implementation of the test into an organized screening program (OSP) is not easy. The aims of this study were to compare the performance and agreement of DS results among three Slovenian cytopathological laboratories involved in the national OSP, and to define cases where staining results can be difficult to interpret. METHODS: Cervical smears were obtained for DS from 129 women referred to colposcopy. Smears were evaluated blindly in three laboratories by a cytotechnologist and a cytopathologist after initial training. Results were positive, suspicious, negative or inadequate. Five characteristics of DS staining were recorded. After primary evaluation, an extensive expert-led additional training was undertaken, including a discussion of difficult cases and a practical exam. Smears were re-evaluated and results compared to primary evaluation. RESULTS: After the additional training, the overall percentage of agreement among the three laboratories increased from 77.5 to 89.9% and kappa increased from 0.70 to 0.86. Sensitivity for CIN2+ increased in two laboratories, to 90.5 and 85.7%, without the loss of specificity (75.8%). In one laboratory, the sensitivity slightly decreased from 90.5 to 88.9%, but the specificity increased from 63.6 to 68.2%. Difficult cases had significantly less DS cells, weak intensity of p16 staining, suboptimal cell morphology and background staining compared to positive cases. CONCLUSION: Additional expert-led training and discussion of difficult cases are necessary for accurate interpretation of DS in laboratories involved in OSP. The most difficult cases were those with single stained cells and weak p16 staining. Training protocol for safe implementation of p16/Ki-67 DS in OSP is proposed.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Interobserver variability and accuracy of p16/Ki-67 dual immunocytochemical staining on conventional cervical smears
- Date Crossref
- 24/05/2019
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Institute of Oncology Ljubljana Department of Cytopathology pays non établi dans la noticeStructure de recherche
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College of Nursing in Celje pays non établi dans la noticeUniversité ou école supérieure
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Izola General Hospital pays non établi dans la noticeÉtablissement de santé
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University Clinical Centre Maribor pays non établi dans la noticeOrganisme public
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Celje General Hospital Department of Pathology and Cytology pays non établi dans la noticeÉtablissement de santé
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General Hospital Izola Department of Pathology and Cytology pays non établi dans la noticeÉtablissement de santé
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University Medical Centre Department of Pathology pays non établi dans la noticeUniversité ou école supérieure
Department of Cytopathology — Institute of Oncology Ljubljana, College of Nursing in Celje et Izola General Hospital, avec 4 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.