子宮頚部細胞診の日米比較―日母分類とベセスダシステム―:日母分類とべセスダシステム  [in Japanese] Comparison of the diagnosis of uterine cervical (Pap.) smears from Japan and the US-Modified Papanicolaou's classification vs The Bethesda System 2001-:Modified Papanicolaou's classification vs The Bethesda System 2001  [in Japanese]

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Abstract

<B>目的:</B>子宮頸部細胞診の日米 (日母分類1997と2001, 年ベセスダシステムに基づく) の診断の違いを検討した.<BR><B>方法:</B>材料は米国で細胞診断医によって診断, 報告された頸部細胞診標本109例を用いた. 日本側の分類を日本の細胞検査士が担当し, 日米の診断を比較した. 完全一致 (complete agreement以下, CA) と部分的一致 (partial agreement以下PA) について検討を行い, さらに米国の意義不明異型扁平上皮細胞 (atypical squamous cells of undetermined significance以下ASC-US) が日本側でどのように分類されているかを調べた.<BR><B>成績:</B>全体としてのCA, PA率はそれぞれ39.4%で, CAは高度扁平上皮内病変 (high-grade squamous intraepithelial lesion以下HSIL), 軽度扁平上皮内病変 (low grade squamous intraepithelial lesion以下HSIL), 反応性変化/陰性, それぞれ, 84.6, 41.4, 74.1%であった. ASC-USは日本側で, それぞれ, 約50, 40%が反応性変化, 軽度異型成 (mild dysplasia) に分類されていた.<BR><B>結論:</B>両国の診断の一致率は比較的高く (CA+PAで約80%), HSILと反応性変化/陰性に関しては, 両国の診断の差異は少ないものと考える. 一方, この間の分類 (特にLSIL) の一致率は低く, 日米の診断システムの違いはこの差によるところが大きいものと考えられる.

<B><I>Objective</I>:</B> We compared differences in the diagnosis of cervicovaginal (Pap.) smears between Japan (modified Papanicolaou classification) and the U. S.(The Bethesda System 2001).<BR><B><I>Study Design</I>:</B> Pap smears from 109 American women previously diagnosed by cytopathologists in the U. S. were independently reexamined by an experienced cytotechnologist in Japan. Original and new cytological diagnoses were compared and classified as complete agreement (CA), partial agreement (PA), and others. Pap smears with a diagnosis of atypical squamous cells of undetermined significance (ASC-US) were classified by Japanese classification.<BR><B><I>Results</I>:</B> Overall CA and PA rates were 39.4%. The CA rate of high-grade intraepithelial lesion (HSIL), was 84.6, of low-grade intraepithelial lesion (LSIL) 41.4, and reactive/negative 74.1%. Approximately 50%, was classified by the Japanese classification as reactive, and 40% of ASC-US as mild dysplasia.<BR><B><I>Conclusion</I>:</B> Overall agreement in cytological diagnoses by two different classifications was relatively high (CA+ PA: about 80%), especially that of HSIL and reactive/negative. Diagnostic criteria for these categories appeared to be equivalent. In contrast, agreement for LSIL diagnosis was low, possibly contributing to the major difference in diagnosis between the two classifications.

Journal

  • The Journal of the Japanese Society of Clinical Cytology

    The Journal of the Japanese Society of Clinical Cytology 44(3), 111-117, 2005

    The Japanese Society of Clinical Cytology

Codes

  • NII Article ID (NAID)
    130003759008
  • Text Lang
    JPN
  • ISSN
    0387-1193
  • Data Source
    J-STAGE 
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