Abstract：
An accurate cytohistologic diagnosis is important to avoid overtreatment of cervical intraepithelial lesions. The three-tiered Cervical Intraepithelial Neoplasia (CIN) classification, grades 1, 2 and 3, despite poor agreement among pathologists in diagnosing CIN2, is still being used. The College of American Pathologists recommended an alternative two-tiered classification that has not yet been universally accepted. We review the diagnostic results of 286 biopsies performed by three pathologists using haematoxylin and eosin (H&E) and p16 to establish the level of agreement among the readers. Agreement between pathologists in diagnosing CIN2 with H&E was around 45% and improved to 86.7% when interpreting p16 stained biopsies without H&E; agreement with pathologist 3 was lower, around 60%. Discrepant results from one pathologist when assessing p16 highlights the decisive influence of individual criteria. P16 has shown to improve agreement between pathologists with previous good agreement, but did not correct it for the third pathologist. In equivocal cases, protein p16 is a useful conjunctive tool for a histologic diagnosis.
摘要：
准确的细胞组织学诊断对于避免宫颈上皮内病变的过度治疗很重要。宫颈上皮内瘤变（CIN）的三级分类，尽管病理学家在诊断CIN2时的一致性较差,但1,2和3级仍在使用.美国病理学家学院推荐了一种尚未被普遍接受的替代两层分类。我们回顾了三位病理学家使用苏木精和伊红（H＆E）和p16进行的286次活检的诊断结果，以建立读者之间的共识水平。病理学家诊断CIN2与H＆E的一致性约为45％，当解释p16染色活检而没有H＆E时提高到86.7％；与病理学家3的一致性较低，60%左右。一位病理学家在评估p16时的差异结果突出了个人标准的决定性影响。P16已显示出改善病理学家与先前良好协议之间的协议，但没有为第三位病理学家纠正。在模棱两可的情况下，蛋白p16是组织学诊断的有用的联合工具。
