Interlaboratory reproducibility in reporting inadequate cervical smears--a multicentre multinational study.

A set of 300 vaginal smears was interpreted by 13 cytologists from six European laboratories, who were requested to report inadequate and suboptimal smears. The set had been appropriately seeded to reach approximately 10% inadequate and 20% suboptimal smear frequency. According to the majority report, 230 smears were classified as adequate (76.7%), 43 as inadequate (14.3%), and 27 as suboptimal (9.0%). Agreement with the majority report ranged from 52% to 91% (average 78%). Kappa statistics for reporting inadequate smears showed a high level of agreement for five cytologists, and fair to good agreement for eight. In contrast, kappa statistics for reporting suboptimal smears showed fair to good agreement with the majority report only in five instances, whereas agreement was poor for eight cytologists. 'Inadequate smear' rates may be used to compare the quality of smears received in different laboratories, as there is a high level of agreement among cytologists as to what constitutes an inadequate smear. However, this is not true for "suboptimal smear" rates, and more precise reporting criteria must be defined and tested if an intermediate category is to be retained to report poor quality smears: more precise reporting criteria must be defined and tested if an intermediate category is to be retained to report poor quality smears.

Performance of the mucinous-like carcinoma-associated antigen in serous effusions.

The mucinous-like carcinoma-associated antigen (MCA), a new tumour marker, was dosed in 150 serous effusions. The levels of MCA were measured by means of an enzyme immunoassay (EIA). Ninety-seven were pleural effusions, 49 were peritoneal effusions and 4 were pericardial effusions. Thirty-five effusions were caused by breast carcinoma, 19 by ovarian carcinoma, 17 by pulmonary carcinoma, 19 by various cancers, while 60 effusions turned out to be of non-neoplastic origin. The results were considered in comparison with the cytologic examination, and the data obtained were also elaborated in terms of sensitivity, specificity, predictive value and test efficiency. The EIA showed satisfactory statistical parameters principally regarding ovarian metastatic cancer. On the other hand, less satisfactory results were extrapolated on breast and lung cancers. Even if further studies are necessary, for example to compare MCA with other seric tumour markers, this experience suggests that MCA could be a satisfactory tumour marker in the diagnosis of metastatic ovarian effusions.

[Quantitative analysis of lymphocyte and monocyte levels in patients after operations for breast cancer]. / Analisi quantitativa dei livelli di linfociti e monociti nelle pazienti operate di carcinoma mammario.

The much less than Quantigen T and B Cell Assay much greater than method is used to evaluate T and B lymphocyte levels, Nuls Cells and monocytes in the peripheral venous blood of patients surgically treated for breast cancer. The results obtained show a change in immune competent cell levels and temporary immune restoration of the immune response during treatment with immunostimulators.