Cytologic-Histologic Correlation Practices for Nongynecologic Cytology Specimens: A Survey by the College of American Pathologists Cytopathology Committee.

Lananh N Nguyen, Barbara A Crothers, Rhona J Souers, Güliz A Barkan, Jennifer Brainard, Aziza Nassar, Susan Rollins, Z Laura Tabatabai, Sana Tabbara, Benjamin Witt, Christine N Booth
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Abstract

Context.—: Cytologic-histologic correlation (CHC) is a Clinical Laboratory Improvement Amendments-mandated requirement for gynecologic cytology, but no similar requirement exists for nongynecologic cytology. This study presents the findings from a College of American Pathologists survey of nongynecologic cytology practice patterns.

Objective.—: To survey the current CHC practices for nongynecologic cytology.

Design.—: Data were analyzed from a survey developed by the committee and distributed to participants in the Nongynecologic Cytopathology Education Program mailing.

Results.—: Adoption of CHC for nongynecologic cytology cases is worldwide, with 88.5% of institutions performing CHC on these specimens, a substantial increase from previous years. Performance of CHC varied by institution type, with clinic or regional/local independent laboratories and national/corporate laboratories performing CHC significantly less frequently than hospitals, university hospitals/academic medical centers, and Veterans Administration/Department of Defense hospital institutions. Most CHC was performed concurrently in real time, when the corresponding surgical specimen was reviewed. Selection for real-time concurrent CHC was by the interpreting pathologist, the pathologist diagnosing the surgical biopsy sample or cytopathology case, or both. Sampling was by far the most common reason for discordance. A 2-step difference was the most frequent threshold for discordance between cytology and surgical specimens, but this criterion varied among institutions, with no majority definition. The positive predictive value of a positive cytology finding was calculated rarely in North American institutions but was calculated more frequently in international institutions.

Conclusions.—: CHC practices for nongynecologic cytopathology mirror those found for CHC of gynecologic cytopathology.

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非妇科细胞学标本的细胞学-组织学相关性实践:美国病理学家学会细胞病理学委员会调查。
背景:细胞学-组织学相关性(CHC)是《临床实验室改进修正案》(Clinical Laboratory Improvement Amendments)规定的妇科细胞学要求,但非妇科细胞学并无类似要求。本研究介绍了美国病理学家学会(College of American Pathologists)对非妇科细胞学实践模式的调查结果:调查美国病理学家学会目前在非妇科细胞学方面的做法:由委员会制定并向非妇科细胞病理学教育计划邮件参与者分发的调查报告中的数据进行了分析:对非妇科细胞学病例采用CHC的机构遍布全球,88.5%的机构对这些标本进行了CHC处理,比前几年有了大幅提高。不同类型的机构采用CHC的情况各不相同,诊所或地区/地方独立实验室以及国家/公司实验室采用CHC的频率明显低于医院、大学医院/学术医疗中心以及退伍军人管理局/国防部医院机构。大多数 CHC 都是在审查相应手术标本时实时同步进行的。实时同步 CHC 由病理解剖医师、诊断手术活检样本或细胞病理学病例的病理医师或两者共同选择。取样是目前最常见的不一致原因。细胞学和手术标本不一致最常见的阈值是两级差异,但这一标准在不同机构之间存在差异,且没有多数定义。北美机构很少计算细胞学阳性结果的阳性预测值,而国际机构则更经常计算这一数值:结论:非妇科细胞病理学的 CHC 实践反映了妇科细胞病理学的 CHC 实践。
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