Abstract：
BACKGROUND: Congo red staining of fat pad fine needle aspiration specimens is a method utilized for evaluation of amyloid deposition. However, these specimens can pose diagnostic challenges for cytopathologists. As part of ongoing internal quality improvement measures, the objective of this study was to evaluate the intradepartmental interobserver agreement of these specimens and to identify factors that affect the variability of the interpretations.
METHODS: There were 7 participants, which included 3 trainees, 3 cytopathologists, and 1 cytotechnologist. Each participant reviewed 50 Congo red stained fat pad fine needle aspiration slides. The interpretations were categorized into 3 groups: negative, indeterminate/suspicious, and positive. The participants also noted any interpretation challenges they encountered for each case.
RESULTS: There was only slight interobserver agreement among all participants (κ = 0.133). Stratified by participant group, the interobserver agreement among the trainees was slight bordering on poor (κ = 0.028) and among cytopathologists was fair (κ = 0.249). The highest agreement between 2 observers was between 2 cytopathologists and the level of agreement was moderate bordering on fair (κ = 0.426). There were only 3 cases (6.0%) with full agreement among observers, while in 25 cases (50.0%), there were 2 category differences in interpretations. The primary diagnostic challenge reported by participants was when weak or focal birefringence was encountered as well as cases complicated by poor stain quality and overstaining.
CONCLUSIONS: We found only slight interobserver agreement among all study participants. A major area of challenge was cases with weak birefringence resulting in high variance of interpretation among participants.
METHODS: There were 7 participants, which included 3 trainees, 3 cytopathologists, and 1 cytotechnologist. Each participant reviewed 50 Congo red stained fat pad fine needle aspiration slides. The interpretations were categorized into 3 groups: negative, indeterminate/suspicious, and positive. The participants also noted any interpretation challenges they encountered for each case.
RESULTS: There was only slight interobserver agreement among all participants (κ = 0.133). Stratified by participant group, the interobserver agreement among the trainees was slight bordering on poor (κ = 0.028) and among cytopathologists was fair (κ = 0.249). The highest agreement between 2 observers was between 2 cytopathologists and the level of agreement was moderate bordering on fair (κ = 0.426). There were only 3 cases (6.0%) with full agreement among observers, while in 25 cases (50.0%), there were 2 category differences in interpretations. The primary diagnostic challenge reported by participants was when weak or focal birefringence was encountered as well as cases complicated by poor stain quality and overstaining.
CONCLUSIONS: We found only slight interobserver agreement among all study participants. A major area of challenge was cases with weak birefringence resulting in high variance of interpretation among participants.
摘要：
背景：脂肪垫细针抽吸标本的刚果红染色是一种用于评估淀粉样蛋白沉积的方法。然而,这些标本可能对细胞病理学家提出诊断挑战。作为正在进行的内部质量改进措施的一部分，这项研究的目的是评估这些标本的部门内部观察者之间的一致性，并确定影响解释变异性的因素。
方法：有7名参与者，其中包括3名学员，3个细胞病理学家，和1位细胞技术专家.每位参与者回顾了50张刚果红染色的脂肪垫细针抽吸载玻片。解释分为3组：阴性，不确定/可疑，和积极的。与会者还注意到他们在每个案件中遇到的任何口译挑战。
结果：所有参与者之间仅有轻微的观察者共识（κ=0.133）。按参与者组分层，学员之间的观察者之间的共识与穷人（κ=0.028）略有接近，而细胞病理学家之间的共识是公平的（κ=0.249）。2位观察者之间的最高一致性是2位细胞病理学家之间的一致性，并且一致性水平是中等水平（κ=0.426）。仅有3例(6.0%)观察者意见完全一致,而在25例(50.0%)中，解释有2个类别的差异。参与者报告的主要诊断挑战是当遇到弱或局灶性双折射时，以及由于染色质量差和过度染色而复杂化的病例。
结论：我们发现所有研究参与者之间仅有轻微的观察者共识。挑战的主要领域是双折射较弱的情况，导致参与者之间的解释差异很大。
方法：有7名参与者，其中包括3名学员，3个细胞病理学家，和1位细胞技术专家.每位参与者回顾了50张刚果红染色的脂肪垫细针抽吸载玻片。解释分为3组：阴性，不确定/可疑，和积极的。与会者还注意到他们在每个案件中遇到的任何口译挑战。
结果：所有参与者之间仅有轻微的观察者共识（κ=0.133）。按参与者组分层，学员之间的观察者之间的共识与穷人（κ=0.028）略有接近，而细胞病理学家之间的共识是公平的（κ=0.249）。2位观察者之间的最高一致性是2位细胞病理学家之间的一致性，并且一致性水平是中等水平（κ=0.426）。仅有3例(6.0%)观察者意见完全一致,而在25例(50.0%)中，解释有2个类别的差异。参与者报告的主要诊断挑战是当遇到弱或局灶性双折射时，以及由于染色质量差和过度染色而复杂化的病例。
结论：我们发现所有研究参与者之间仅有轻微的观察者共识。挑战的主要领域是双折射较弱的情况，导致参与者之间的解释差异很大。
