Validez de criterio y reproductividad de la lectura guiada en la citología cérvico-vaginal / Utility of a guided reading technique for cervical cancer screening
Colomb. med
; 37(2): 142-147, abr.-jun. 2006. ilus, tab
Article
in Spanish
| LILACS
| ID: lil-585809
Responsible library:
CO49.1
RESUMEN
Contexto:
La lectura de la citología cérvico-vaginal sigue un patrón que puede omitir sectores donde haya nidos de células anormales. Se ha diseñado una estrategia de guía de la lectura de bajo costo.Objetivo:
Establecer la validez de criterio y la reproductividad de la lectura guiada sobre la capacidad de discriminar la citología cérvico-vaginal.Metodología:
En 300 mujeres sin historia de cáncer de cuello uterino se tomaron dos láminas de citología cérvico-vaginal; ambas se leyeron con el método regular para posterior reevaluación oculta con técnica guiada. Se calcularon los indicadores diagnósticos de las lecturas regular y guiada de cada lámina (patrón de oro lectura por patólogo).Resultados:
Hubo 65 (21.7%) mujeres con citología positiva en la lectura regular, mientras que 64 (21.3%) lo fueron en la lectura guiada. La concordancia de la lectura regular (Kappa 0.354; IC 95% 0.250-0.457) mejoró con la lectura guiada (Kappa 0.395; IC 95% 0.285-0.505). De las placas 24.3% fueron positivas en la lectura por patólogo (2.7% con lesión de alto grado de malignidad). La lectura guiada mejoró los indicadores de validez de criterio.Conclusión:
La lectura guiada mejora los indicadores de desempeño, y corrige parcialmente las fallas humanas en la lectura. Sin embargo, esto se debe verificar en estudios poblacionales.ABSTRACT
Background:
Reading of Papanicolaou test slides follows a pattern that could omit sectors with abnormal cell nests. A low-cost guided reading strategy has been designed.Aim:
To establish criteria validity and reproducibility of guided reading strategy in cervical uterine Pap smear.Methodology:
To each of 300 women without cervical cancer history in order to apply Papanicolaou test, two slides were taken; both slides were read by regular method, and then reevaluated in blinded conditions with a guided technique. Diagnosis accuracy of regular and guided techniques was determined using pathologists reading as a gold standard.Results:
When regular readings were used 65 (21.7%) of women had abnormal cytology, and 64 (21.3%) had also abnormal readings with the guided technique. Concordance of the regular reading (Kappa 0.354; 95% CI 0.250-0.457) improved with the guided technique (Kappa 0.395; 95% CI 0.285-0.505), while 24.3% slides were found abnormal in gold standard (2.7% with a high degree of malignancy). The guided reading improves all criteria validity indicators.Conclusion:
This study demonstrated that the guided reading improves criteria validity indicators, correcting some technician mistakes; however, a populational study is necessary to confirm these results.
Full text:
Available
Collection:
International databases
Database:
LILACS
Main subject:
Women
/
Uterine Cervical Neoplasms
/
Cell Biology
/
Population Studies in Public Health
Type of study:
Diagnostic study
/
Practice guideline
/
Screening study
Language:
Spanish
Journal:
Colomb. med
Journal subject:
Medicine
Year:
2006
Document type:
Article
Affiliation country:
Colombia
Institution/Affiliation country:
Liga Santandereana de Lucha contra el Cáncer/CO
/
Universidad Autónoma de Bucaramanga/CO