Interlaboratory reproducibility of atypical glandular cells of undetermined significance: A national survey

M. Confortini, L. Di Bonito, F. Carozzi, B. Ghiringhello, G. Montanari, F. Parisio, S. Prandi, Roberto Navone, Silvana Pilotti, Loredana Alasio, Sonia Prandi, Maria Paola Cariaggi, Gianluigi Taddei, Cesare Gentili, Basilio Passamonti, Emilio Bucciarelli, Carlo Di Giacomo, Antonella Pellegrini, M. Luisa Schiboni, Maurizio Di BonitoFerdinando Quarto, Gerardo Botti, M. Luisa De Falco, Luigi Di Bonito, Gianni Simone, Sarah Wiesel, Luigi Tucci, Teresa Bustinto, Domenico Ientile, Marco Rais, Aurora Scalisi, Giuseppe Grasso, Paolo Dalla Palma, Daria Minucci, Vito Ninfo, Marcello Vettorazzi

Research output: Contribution to journalArticlepeer-review


Objective: The aim of this study was to evaluate the inter-laboratory reproducibility for atypical glandular cells (AGC) (The Bethesda System (TBS) 2001) of the laboratories involved in the screening programmes in Italy. Methods: A set of 35 selected slides were circulated among 167 laboratories involved in local population-based cervical screening programmes. Each laboratory provided one single diagnosis per smear. The smears were read blind to the original diagnosis and to the diagnoses provided by other laboratories. A 'majority' diagnosis was defined for each case and assumed as the reference standard. The diagnosis provided from each laboratory was compared with the majority diagnosis. Results: According to the majority report the 35 slides in the set were classified as negative in nine cases, AGC in eight, adenocarcinoma in eight, and squamous lesion or squamous + glandular lesion in 10. The crude agreement between all pairs of laboratories was 49.43%. K-values were 0.46, 0.21, 0.34, 0.36 and 0.32 for negative, AGC/AIS (adenocarcinoma in situ of endocervix), AdenoCa, Sq/Sq + Gl and all reporting categories respectively. Concordance according to overall K was moderate to substantial in 77% of the participating laboratories. Conclusions: The present study shows that the AGC category is not easily reproducible. The data confirmed the importance, in a screening scenario, of AGC/AIS diagnoses, but also presented difficulties in differentiating between the two diagnoses. In addition to the results obtained from the circulation of the slides, laboratories which had annually a low number of cervical smears were able to gain experience focused on particular morphological pictures.

Original languageEnglish
Pages (from-to)353-360
Number of pages8
Issue number6
Publication statusPublished - Dec 2006


  • AGC
  • Cervical adenocarcinoma
  • Cervical screening
  • Cytodiagnosis
  • Cytological techniques
  • Cytology
  • Diagnosis
  • Glandular lesions
  • Laboratory diagnosis
  • Reproducibility
  • Screening

ASJC Scopus subject areas

  • Anatomy
  • Cell Biology


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