Diagnostic and treatment reproducibility of cervical intraepithelial neoplasia/squamous intraepithelial lesion and factors affecting the diagnosis

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dc.contributor.authorSağlam A.
dc.contributor.authorUsubütün A.
dc.contributor.authorDolgun A.
dc.contributor.authorMutter G.L.
dc.contributor.authorCoşkun Salman M.
dc.contributor.authorKurtulan O.
dc.contributor.authorAkyol A.
dc.contributor.authorÖzkan E.A.
dc.contributor.authorBaykara S.
dc.contributor.authorBülbül D.
dc.contributor.authorCalay Z.
dc.contributor.authorEren F.
dc.contributor.authorGümürdülü D.
dc.contributor.authorHaberal N.
dc.contributor.authorİlvan Ş.
dc.contributor.authorKaravelı Ş.
dc.contributor.authorKoyuncuoğlu M.
dc.contributor.authorMüezzınoğlu B.
dc.contributor.authorMüftüoğlu K.H.
dc.contributor.authorÖzen Ö.
dc.contributor.authorÖzdemır N.
dc.contributor.authorPeşterelı E.
dc.contributor.authorUlukuş Ç.
dc.contributor.authorZekİoğlu O.
dc.date.accessioned2019-10-27T08:20:21Z
dc.date.available2019-10-27T08:20:21Z
dc.date.issued2017
dc.departmentEge Üniversitesien_US
dc.description.abstractObjective: Inter-observer differences in the diagnosis of HPV related cervical lesions are problematic and response of gynecologists to these diagnostic entities is non-standardized. This study evaluated the diagnostic reproducibility of “cervical intraepithelial neoplasia” (CIN) and “squamous intraepithelial lesion” (SIL) diagnoses. Material and Method: 19 pathologists evaluated 66 cases once using H&E slides and once with immunohistochemical studies (p16, Ki-67 and Pro-ExC). Management response to diagnoses was evaluated amongst 12 gynecologists. Pathologists and gynecologists were also given a questionnaire about how additional information like smear results and age modify diagnosis and management. Results: We show moderate interobserver diagnostic reproducibility amongst pathologists. The overall kappa value was 0.50 and 0.59 using the CIN and SIL classifications respectively. Impact of immunohistochemical evaluation on interpretation of cases differed and there was lack of statistically significant improvement of interobserver diagnostic reproducibility with the addition of immunohistochemistry. We saw that choice of treatment methods amongst gynecologists varied and overall concordance was only fair to moderate. The CIN2 diagnostic category was seen to have the lowest percentage agreement amongst both pathologists and gynecologists. We showed that pathologists had diagnostic “styles” and gynecologists had management “styles”. Conclusion: In summary each pathologist had different diagnostic tendencies which were affected not only by histopathology and marker studies, but also by the patient management tendencies of the gynecologist that the pathologist worked with. The two-tiered modified Bethesda system improved diagnostic agreement. We concluded that immunohistochemistry should be used only to resolve problems in select cases and not for every case. © 2017, Federation of Turkish Pathology Societies. All rights reserved.en_US
dc.description.sponsorshipIdaho Humanities Council, IHCen_US
dc.description.sponsorshipWe thank Sitogen and BD for providing the IHC markers for the study and we thank ?zlem Kalaycl for her technical assistance. --en_US
dc.identifier.doi10.5146/tjpath.2017.01400en_US
dc.identifier.endpage191en_US
dc.identifier.issn1018-5615
dc.identifier.issue3en_US
dc.identifier.pmid28832077en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage177en_US
dc.identifier.urihttps://doi.org/10.5146/tjpath.2017.01400
dc.identifier.urihttps://hdl.handle.net/11454/25616
dc.identifier.volume33en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherFederation of Turkish Pathology Societiesen_US
dc.relation.ispartofTurk Patoloji Dergisien_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectCINen_US
dc.subjectDiagnosisen_US
dc.subjectGynecologisten_US
dc.subjectInterobserver reproducibilityen_US
dc.subjectSILen_US
dc.titleDiagnostic and treatment reproducibility of cervical intraepithelial neoplasia/squamous intraepithelial lesion and factors affecting the diagnosisen_US
dc.typeArticleen_US

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