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Objectives: To determine histologic positive predictive values (PPVs) for three categories of cytologic reports of endocervical glandular abnormalities.Materials and Methods: We obtained histologic follow-up for 100% of 67 cytologic predictions of adenocarcinoma in situ (AIS) and 82% of 39 predictions of possible AIS (?AIS) made over a 4-year period (1999-2002) and for 25% of 105 atypical endocervical cells (AEC) predictions over a 12-month period (2000). For each category of cytologic report, we determined the histologic yields of high-grade lesions overall and of high-grade glandular lesions.Results: PPVs for predictions of AIS and ?AIS for high-grade lesions overall were 91% and 75% (p = .032), respectively, and those for high-grade glandular lesions were 88% and 72% (p = .046), respectively. For a cytologic report of AEC, of those with histologic follow-up, 9% had a high-grade lesion and 7% had a high-grade glandular lesion.Conclusion: Cytology can accurately predict AIS. [ABSTRACT FROM AUTHOR]

In a natural history study of anal human papillomavirus (HPV) infection and HPV-related lesions, we examined the reproducibility of histological high-grade squamous intraepithelial lesion (HSIL). Three expert anogenital pathologists share the reporting of histological specimens from the Study of the Prevention of Anal Cancer (SPANC), utilising Lower Anogenital Squamous Terminology (LAST) criteria. In total, 194 previously reported biopsies were randomly chosen within diagnostic strata [50 HSIL-anal intraepithelial neoplasia (AIN) 3; 45 HSIL-AIN 2; 49 'flat' low-grade squamous intraepithelial lesion (LSIL); 50 'exophytic' LSIL; and 50 negative for squamous intraepithelial lesion] and reviewed by each of these three pathologists. Consensus was defined as agreement between at least two review diagnoses, using a binary classification of HSIL and non-HSIL, or if consensus was not obtained in this way, it was achieved through a multiheader microscope session by the three pathologists. We found very high agreement between original and consensus diagnoses (Kappa = 0.886) and between each pathologist's review and consensus (Kappas = 0.926, 0.917 and 0.905). Intra-observer agreement for the three pathologists was 0.705, 1.000 and 0.854. This high level of diagnostic reproducibility indicates that the findings of SPANC should be robust and provide reliable information about HPV-related anal canal disease.