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Statistical quality control in cervical-vaginal cythology : ASC-US/SIL Ratio

By González, Yury, Sabiana, Cytotechnician

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Book Id: WPLBN0004451018
Format Type: PDF (eBook)
File Size: 249.22 KB.
Reproduction Date: 9/1/2016

Title: Statistical quality control in cervical-vaginal cythology : ASC-US/SIL Ratio  
Author: González, Yury, Sabiana, Cytotechnician
Volume:
Language: English
Subject: Non Fiction, Medicine, Anatomy, morphology, cytology
Collections: Authors Community, Medicine
Historic
Publication Date:
2016
Publisher: Medical Diagnostics of Chiriqui
Member Page: Rolando Alvarado Anchisi

Description
Scientific white paper made in a small pathology lab in Latin America.

Summary
Use of the ratio between ASC-US and SIL as a quality control tool in conventional exfoliative cervico-vaginal cytology.

Excerpt
Introduction Uterine cervix cancer is the second most common neoplasm in women. Of all uterine cervix and vagina cytologies, between 0,5 and 0,6% reveal high-grade squamous intraepithelial lesion (HSIL), and between 2 and 3% are low-grade squamous intraepithelial lesions (LSIL). The tem ASC-US (atypical squamous cells, of undetermined significance) is a diagnostic category, not a biological entity, that comprises inflammatory, reactive and reparative processes. In our revision of the literature, we found that ASC-US diagnosis comprises between 1,6 and 9% of the diagnosis, with an average around 5%. Other authors have employed with success the use of a ration between ASC-US and SIL as statistical quality control tool, whose value should not surpass 3,0. Research methods It's a descriptive, retrospective study, based on the total of cervico-vaginal cytologies processed and diagnosed in this lab, since opening on July 1st, 2008 until December 31st, 2015. Results We found a total of 58,289 cervico-vaginal exfoliative cytologies. From which 974 were diagnosed as ASC-US and 925 as SIL. The ASC-US/SIL ratio was, on average 1,16, with a standard deviation of 0,31. The range of the ASC-US/SIL ratio was between 0,69 and 1,67. The ASC-US diagnoses represented 1,67%, whereas the SIL diagnosis were 1,59% of all cases. ASC-US had an average of 2,06%, with a standard deviation of 0,99%, in a range between 0,67 and 4,09%. SIL had an average of 1,79%, with a standard deviation of 0,68%, in a range between 0,69 and 2,79%. Discussion We found yearly variations of ASC-US/SIL ratio, that we attribute to human factors such as work load. In 2010, ASC-US/SIL ratio was set below one standard deviation from average, and in 2012 it was set above one standard deviation from average. Our ASC-US and SIL percentages were well below figures found in bibliographical references. Both figures also showed yearly variations. There was overdiagnosis of ASC-US in 2008, and of SIL in 2008 and 2010. Conclusion To the extent of what we've been able to investigate, this is the first article about statistical quality control for uterine cervix and vagina cytology in Panama. Nevertheless, we still believe it is important to compare our findings with other labs willing to publish their results, to determine is ours constitute the statistical rule of the region or if they are an statistical annomay, favorable or disfavorable.

Table of Contents
Index.................................................................2 Executive summary.....................................................3 Introduction..........................................................4 Research methods......................................................5 Results...............................................................6 Discussion............................................................8 Conclusions...........................................................9 Bibliographical references...........................................10 Appendices...........................................................12

 

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