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Evaluation of the training program for p16/ Ki-67 dual immunocytochemical staining interpretation for laboratory staff without experience in cervical cytology and immunocytochemistry

Veronika Kloboves Prevodnik

Veronika Kloboves Prevodnik

  • Department of Cytopathology, Institute of Oncology LjubljanaLjubljana, Slovenia
  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
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Prevodnik, Veronika Kloboves
, 
Ziva Pohar Marinsek

Ziva Pohar Marinsek

Department of Cytopathology, Institute of Oncology LjubljanaLjubljana, Slovenia
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Marinsek, Ziva Pohar
, 
Janja Zalar

Janja Zalar

Department of Cytopathology, Institute of Oncology LjubljanaLjubljana, Slovenia
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Zalar, Janja
, 
Hermina Rozina

Hermina Rozina

Department of Cytopathology, Institute of Oncology LjubljanaLjubljana, Slovenia
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Rozina, Hermina
, 
Nika Kotnik

Nika Kotnik

Department of Experimental Allergology and Immunodermatology Oldenburg, Carl von Ossietzky UniversitätOldenburg, Germany
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Kotnik, Nika
, 
Tine Jerman

Tine Jerman

Epidemiology and Cancer Registry, Institute of Oncology LjubljanaLjubljana, Slovenia
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Jerman, Tine
, 
Jerneja Varl

Jerneja Varl

  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
  • Department of Experimental Oncology, Institute of Oncology LjubljanaLjubljana, Slovenia
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Varl, Jerneja
 and 
Urska Ivanus

Urska Ivanus

  • Epidemiology and Cancer Registry, Institute of Oncology LjubljanaLjubljana, Slovenia
  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
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Ivanus, Urska
  
Mar 26, 2020
Evaluation of the training program for p16/ Ki-67 dual immunocytochemical staining interpretation for laboratory staff without experience in cervical cytology and immunocytochemistry's Cover Image
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Article Category: Research Article
Published Online: Mar 26, 2020
Page range: 201 - 208
Received: Jan 22, 2020
Accepted: Mar 04, 2020
DOI: https://doi.org/10.2478/raon-2020-0018
Keywords
© 2020 Veronika Kloboves Prevodnik, Ziva Pohar Marinsek, Janja Zalar, Hermina Rozina, Nika Kotnik, Tine Jerman, Jerneja Varl, Urska Ivanus, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Study flow chart with histopathology follow-up results.
Study flow chart with histopathology follow-up results.

Figure 2

Sensitivity and specificity of p16/Ki-67 dual immunocytochemical staining (DS) for detecting CIN2+ for both students and the teacher (senior cytotechnologist).S1= student 1; S2 = student 2; SC (S1) = senior cytotechnologist – slide review after S1; SC (S2) = senior cytotechnologist – slide review after S2
Sensitivity and specificity of p16/Ki-67 dual immunocytochemical staining (DS) for detecting CIN2+ for both students and the teacher (senior cytotechnologist).S1= student 1; S2 = student 2; SC (S1) = senior cytotechnologist – slide review after S1; SC (S2) = senior cytotechnologist – slide review after S2

Figure 3

Sensitivity and specificity for the results of both students and the reference according to the number of evaluated slides.S1 = student 1; S2 = student 2
Sensitivity and specificity for the results of both students and the reference according to the number of evaluated slides.S1 = student 1; S2 = student 2

Figure 4

Joinpoint regression analysis of students’ screening times.S1 = student 1; S2 = student 2
Joinpoint regression analysis of students’ screening times.S1 = student 1; S2 = student 2

Individual comparison of p16/Ki-67 agreement and performance between students, senior technologist and reference

TrainingReviewersOPAMcNemar’s test pκ (cohen) (95% CI)
S1/Reference81.4%0.0000.512 (CI: 0.329–0,696)
S2/Reference81.4%0.0060.527 (CI: 0.349–0,705)
Initial trainingSC (S1)/ Reference94.1%0.1310.859 (CI: 0.758–0.960)
(N = 118)SC (S2)/ Reference94.1%0.1310.859 (CI: 0.758–0.960)
SC (S1)/SC (S2)100.0%/1.000 (CI: /)
S1/Reference78.3%0.0000.556 (Cl: 0.472–0.641)
S2/Reference87.2%0.7750.713 (Cl: 0.638–0.788)
Addtional (N = 383)SC (S1)/Reference86.2%0.0060.700 (Cl: 0.625–0,775)
SC (S2)/Reference86.4%0.0040.707 (Cl: 0.632–0.781)
SC (S1)/SC (S2)98.7%1.0000.973 (CI: 0.949–0.996)

p16/Ki-67 study results and CIN2+ outcome for students, senior cytotechnologist and reference

ReviewerCategories of p16/Ki67 dual staining resultInitial training (N = 118)Additional training (N = 383)
p16/Ki67 dual staining result N, (%)CIN2+ outcomes N (PV, %)*p16/Ki67 dual staining result (N, %)CIN2+ outcomes N (PV, %)*
positive91 (77.1)65 (71.4)171 (44.6)65 (38.0)
S1suspicious7 (5.9)2 (28.6)7 (1.8)2 (28.6)
negative20 (16.9)2 (10.0)205 (53.5)10 (4.9)
unsatisfactory0 (0.0)0 (0.0)0 (0.0)0 (0.0)
positive92 (78.0)66 (71.7)129 (33.7)64 (49.6)
S2suspicious2 (1.7)0 (0.0)1 (0.3)1 (100.0)
negative24 (20.3)3 (12.5)253 (66.1)12 (4.7)
unsatisfactory0 (0)0 (0.0)0 (0.0)0 (0.0)
positive83 (70.3)65 (78.3)143 (37.9)65 (45.5)
suspicious2 (1.7)2 (100.0)5 (1.3)0 (0.0)
SC (S1)negative32 (27.1)2 (6.3)235 (61.4)12 (5.1)
unsatisfactory1 (0.8)0 (0.0)0 (0.0)0 (0.0)
positive83 (70.3)65 (78.3)145 (37.9)64 (44.1)
suspicious2 (1.7)2 (100.0)4 (1.0)0 (0.0)
SC (S2)negative32 (27.1)2 (6.3)234 (61.1)13 (5.6)
unsatisfactory1 (0.8)0 (0.0)0 (0.0)0 (0.0)
positive78 (66.1)64 (82.1)114 (29.8)64 (56.1)
Referencesuspicious2 (1.7)0 (0)13 (3.4)3 (23.1)
negative38 (32.2)5 (13.2)255 (66.6)10 (3.9)
unsatisfactory0 (0.0)0 (0.0)1 (0.3)0 (0.0)
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