[Diagnostic concordance in gynecologic cytology].
OBJECTIVE
To evaluate the diagnostic agreement in Papanicolaou of pathologists and cytotechnologists using kappa values for concordancy.


METHODS
The diagnostic variation was estimated in 20 gynecological cytology (Pap) specimens by 30 pathologists and 7 cytotechnologists attending the XXXVII Congress of the Mexican Association of Pathologists in 1994.


RESULTS
The best concordancy versus an expert was in tumoral diathesis (pathologists' kappa = 0.36; cytotechnologists' kappa = 0.35) and kollocytos (pathologists' kappa = 0.55; cytotechnologists' kappa = 0.36). The least concordancy was observed in anisonucleosis (pathologists' kappa = 0.11; cytotechnologists' kappa = 0.02), nuclear hyperchromasia (pathologists' and cytotechnologists' kappa = 0.11) and dyskeratosis (pathologists' kappa = 0.11; cytotechnologists' kappa = 0.16). The kappa values for cervical neoplasia showed poor agreement, and in invasive cervical cancer it was 0.30.


CONCLUSIONS
There was a low concordancy of Pap diagnosis in the study. It is convenient to try to improve the concordancy of cytologic diagnosis in Mexico. One strategy could be the use of a uniform diagnostic criteria and the adoption of a single nomenclature.
Lazcano Ponce
E C
EC
Centro de Investigaciones en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
de Ruiz
P A
PA
Martínez Arias
C
C
Murguía Riechers
L
L
D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology; D002467:Cell Nucleus / Q000648:ultrastructure; D002584:Cervix Uteri / Q000166:cytology; D005260:Female; D006801:Humans; D008800:Mexico; D015588:Observer Variation; D065006:Papanicolaou Test; D015203:Reproducibility of Results; D002577:Uterine Cervical Diseases / Q000145:classification / Q000175:diagnosis* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology; D014626:Vaginal Smears / Q000592:standards / Q000706:statistics & numerical data