Literature DB >> 28110502

Accuracy and Reproducibility of Nuclear/Cytoplasmic Ratio Assessments in Urinary Cytology Specimens.

Lester J Layfield1, Magda Esebua1, Shellaine R Frazier1, Richard D Hammer1, William W Bivin1, Van Nguyen1, Ilker Ersoy1, Robert L Schmidt2.   

Abstract

BACKGROUND: Evaluation of the nuclear to cytoplasmic ratio is commonly used for assessment of the presence of n class="Disease">malignancy and for grading and typing of malignant neoplasms. Despite its widespread usage, little information exists regarding the accuracy and reproducibility of non-automated assessment.
METHODS: Forty-seven cells obtained from Papanicolaou stained urine cytologies were assessed by quantitative image analysis for nuclear area and cell area. The nuclear/cytoplasmic ratio was calculated. Visual estimates of the N/C ratio were made by six pathologists. Statistical analysis was performed to determine accuracy, precision, and interrater reliability.
RESULTS: True N/C ratios varied from 0.02 to 0.81. 27% of cases demonstrated a true N/C ratio between 0.5 and 0.7. Quantitative estimates of N/C ratios were less precise and less accurate at high N/C ratios. The coefficient of variation was 27%. The majority of raters demonstrated decreased accuracy and precision of estimates as N/C ratio increased. Overall classification accuracy was 73%. Accuracy of classification was 53% for cases with a true N/C ratio between 0.4 and 0.8. Absolute interrater agreement was 75%. Chance corrected agreement (kappa) was 0.54.
CONCLUSIONS: Visual quantitation of N/C ratio showed only a fair correlation with actual N/C ratio with correlation decreasing with increasing N/C ratio. In the critical range, 0.5-0.7 N/C ratio both interobserver correlation and correlation with true N/C ratio may be insufficiently accurate for precise category assignment as used in the Paris System. Diagn. Cytopathol. 2017;45:107-112.
© 2016 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Entities:  

Keywords:  cytology; interobserver agreement; nuclear/cytoplasmic ratio; urine; urothelial carcinoma

Mesh:

Year:  2017        PMID: 28110502     DOI: 10.1002/dc.23639

Source DB:  PubMed          Journal:  Diagn Cytopathol        ISSN: 1097-0339            Impact factor:   1.582


  8 in total

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Journal:  Cytotechnology       Date:  2018-02-14       Impact factor: 2.058

2.  Interobserver reproducibility of The Paris System for Reporting Urinary Cytology.

Authors:  Theresa Long; Lester J Layfield; Magda Esebua; Shellaine R Frazier; D Tamar Giorgadze; Robert L Schmidt
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7.  Diagnostic Agreement for High-Grade Urothelial Cell Carcinoma in Atypical Urine Cytology: A Nationwide Survey Reveals a Tendency for Overestimation in Specimens with an N/C Ratio Approaching 0.5.

Authors:  Yeh-Han Wang; Jen-Fan Hang; Chien-Hui Wen; Kuan-Cho Liao; Wen-Ying Lee; Chiung-Ru Lai
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  8 in total

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