Interobserver variation in the reporting of cervical colposcopic biopsy specimens: Comparison of grading systems
Interobserver variation in the reporting of cervical colposcopic biopsy specimens: Comparison of grading systems
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DOI：
10.1136/jcp.49.10.833
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发表时间：
1996-10-01
影响因子：
3.4
通讯作者：
Walsh, MY
中科院分区：
文献类型：
--
作者：
McCluggage, WG;Bharucha, H;Walsh, MY
Aims-To assess interobserver variation in reporting cervical coloscopic biopsy samples and to determine whether a modified Bethesda grading system results in better interobserver agreement than the traditional cervical intraepithelial neoplasia（CIN）grading system. Methods-125 continuous cervical coloscopic biopsy samples were assessed independently by six histopathologists.使用传统的CIN分级系统将样本分类为正常、挖空细胞、CIN I、CIN II或CIN III。采用改良的Bethesda分级系统将标本分为正常、低度鳞状上皮内病变（LSIL）或高度鳞状上皮内病变（HSIL）。参与者还被要求通过CIN系统对活检标本进行分类，并增加了最近提出的类别“不确定意义的基础异常（BAUS）”。参与者之间的协议程度进行了评估kappa statistics.Results-Using的CIN系统，interobserver协议普遍较差：未加权和加权的kappa值之间的观察者对范围从0.05至0.34（平均0.20）和从0.20至0.54（平均0.36），分别。使用改良Bethesda系统，观察者间一致性较好，但仍然较差：未加权和加权Kappa值分别为0.15 - 0.58（平均0.30）和0.21 - 0.61（平均0.36）。有很少或没有观察者之间的诊断BAUS. Conclusion-Interobserver协议在宫颈阴道镜活检标本的CIN分级系统的报告是穷人。协议，同时。差，是更好的，当使用修改后的贝塞斯达分级系统。在BAUS的诊断方面很少或没有共识。
Aims-To assess interobserver variation in reporting cervical colposcopic biopsy specimens and to determine whether a modified Bethesda grading system results in better interobserver agreement than the traditional cervical intraepithelial neoplasia (CIN) grading system.Methods-One hundred and twenty five consecutive cervical colposcopic biopsy specimens were assessed independently by six histopathologists. Specimens were classified using the traditional CIN grading system as normal, koilocytosis, CIN I, CIN II, or CIN III. The specimens were also classified using a modified Bethesda grading system as either normal, low grade squamous intraepithelial lesion (LSIL) or high grade squamous intraepithelial lesion (HSIL). Participants were also asked to categorise biopsy specimens by the CIN system with the addition of the recently proposed category ''basal abnormalities of uncertain significance (BAUS)''. The degree of agreement between participants was assessed by kappa statistics.Results-Using the CIN system, interobserver agreement was generally poor: unweighted and weighted kappa values between individual pairs of observers ranging from 0.05 to 0.34 (average 0.20) and from 0.20 to 0.54 (average 0.36), respectively. With the modified Bethesda system, interobserver agreement was better but still poor: unweighted and weighted kappa values ranging from 0.15 to 0.58 (average 0.30) and from 0.21 to 0.61 (average 0.36), respectively. There was little or no agreement between observers in the diagnosis of BAUS.Conclusions-Interobserver agreement in the reporting of cervical colposcopic biopsy specimens using the CIN grading system is poor. Agreement, while still. poor, is better when a modified Bethesda grading system is used. There is little or no consensus in the diagnosis of BAUS.