A.--  USERS'S  GUIDE

1. INTRODUCTION

1.1. THE NEED FOR EVALUATION OF THE HISTOPATHOLOGICAL AND CYTOLOGICAL FINDINGS

1.2. PREPARATIONS FOR AUTOMATED DATA PROCESSING

1.2.1. Coding by SNOP

1.2.2. Multiple-copies system

1.2.3. Cumulative surveys by manual method

1.2.4. Shortcomings of the manual data handling

1.3. AUTOMATED DATA PROCESSING

1.3.1. Results of the automated data processing

1.3.2. Data entry

1.3.3. Hardware

1.3.4. Software

2. PRINCIPLES OF CLASSIFICATION OF THE FINDINGS

       2.1. CLASSIFICATION OF THE FINDINGS BY TOPOGRAPHY

      2.1.1. First stratum of classification and observation

      2.1.2. Second stratum of classification and observation

      2.1.3. Third stratum of classification and observation

      2.1.4. Fourth stratum of data classification and observation

2.2. CLASSIFICATION OF HISTOPATHOLOGICAL FINDINGS BY MORPHOLOGY

2.2.1. First stratum of classification and observation

2.2.2. Second stratum of classification and observation

2.2.3. Third stratum of classification and observation

2.2.4. Fourth stratum of classification and observation

2.3. CLASSIFICATION OF THE CYTOLOGICAL FINDINGS

2.3.1. First stratum of classification and observation by topography

2.3.2. Second stratum of classification and observation by topography

2.3.3. Third stratum of classification and observation by topography

2.3.4. Fourth stratum of classification and observation by topography

2.3.5. First stratum of classification and observation of cytological findings by expected histopathological diagnoses

2.3.6. Second stratum of classification and observation of cytological findings by expected histopathological iagnoses

2.3.7. Third stratum of classification and observation of cytological findings by expected histopathological iagnoses

2.4. CUMULATION OF THE FINDINGS

3. COMMENTS ON THE CLASSIFIED HISTOPATHOLOGICAL FINDINGS BY TOPOGRAPHY FOR 1989-2009

3.1. FIRST STRATUM OF CLASSIFICATION BY ORGANIC SYSTEMS

3.2. SECOND STRATUM OF CLASSIFICATION - PARTICULAR LOCATIONS AND SITES

3.2.1. Second stratum: female genital tract

3.2.2. Second stratum: digestive system

3.2.3. Second stratum: skin

3.2.4. Second stratum: head and neck 

3.3. THIRD STRATUM OF CLASSIFICATION - HISTOPATHOLOGICAL DIAGNOSES AT PARTICULAR TOPOGRAPHIC SITES

3.3.1. Third stratum: female genital tract

3.3.2. Third stratum: digestive tract

3.3.3. Third stratum: skin

3.3.4. Third stratum: head and neck

3.4. THE FOURTH STRATUM

4. COMMENTS ON THE CLASSIFIED HISTOPATHOLOGICAL FINDINGS BY MORPHOLOGY FOR 1989-2009

4.1. FIRST STRATUM OF CLASSIFICATION ACCORDING TO SNOP GROUPS OF DIAGNOSES

4.2. SECOND STRATUM OF CLASSIFICATION OF THE SECTION GROWTH ALTERATIONS

4.2.1. Third stratum of classification of the section growth alterations

4.3. SECOND STRATUM OF CLASSIFICATION OF NEOPLASMS

4.3.1.Distribution of squamous cell carcinomas by specific locations - third stratum

4.3.2. Distribution of adenocarcinomas by specific locations - third stratum

4.3.3. Occasional - rare neoplasms

4.4. CLASSIFICATION OF INFLAMMATIONS AND FIBROSES

4.4.1. Locations of chronic inflammations

4.4.2. Locations of ulcers

4.4.3. Localizations of granulomatous inflammations

4.4.4. Localizations of specific granulomatous inflammations

4.5. CLASSIFICATION OF UNSPECIFIED OR DESCRIPTIVE FINDINGS

4.6. CLASSIFICATION OF CONGENITAL MALFORMATIONS

4.7. CLASSIFICATION OF MECHANICAL ABNORMALITIES, DEGENERATIONS, NECROSES AND DEPOSITS

5. COMMENTS ON THE CLASSIFIED CYTOLOGICAL FINDINGS

5.1. CLASSIFICATION OF TOPOGRAPHY

5.1.1. First stratum: classification groups and organic systems (1989-2009)

5.1.2. Second stratum: classification groups and specified localizations (1989-2009)

5.1.3. Third stratum: classification groups, specified localizations and expected histopathological diagnoses (1993-2009 only)

5.2. CLASSIFICATION OF MORPHOLOGY

5.2.1. First stratum of classification      (1993-2009)

5.2.2. Second stratum of classification  (1993-2009)

5.2.3. Third stratum of classification     (1993-2009)

6. ANNEX (COMMENTS)

6.1. TYPES OF HISTOPATHOLOGICAL SPECIMENS IN 2009

6.2. TYPES OF CYTOLOGICAL SPECIMENS IN 2009

6.3. NUMBER OF PARAFFIN BLOCKS IN 2009

6.4. FREQUENCY OF HISTOPATHOLOGICAL AND CYTOLOGIC FINDINGS IN 2009 BY MEDICAL INSTITUTIONS

6.5. WORKLOAD OF PHYSICIANS IN 2009 AND 1989-2009

6.6. WORKDAYS SPENT FOR COMPLETION OF HISTOPATHOLOGICAL REPORTS IN 2009

6.7. EVALUATION OF CLINICAL DIAGNOSES

6.8. EXAMPLES OF CROSSTABULATION

6.9. An example of every month corelation of gynecolocical cervical cytology and histopathology

6.10. POSSIBLE IMPACT OF TREATED DYSPLASIAS AND CARCINOMA IN SITU FOUND IN AN OPORTUNISTIC CYTOLOGIC SCREENING ON CERVICAL INVASIVE CARCINOMA IN MACEDONIA IN 2004

6.11.Differences  between  definitive  arbitrary    histopathological diagnosis of   cervical  intraepithelial carcinoma and previous cytological and biopsy findings. 2005,2008,2007,2008. N = 624.

6.12. REALISED DIAGNOSTIC VALUE OF VAGINAL CYTODIAGNOSTIC OF PATIENTS WITH INVASIVE CERVICAL CARCINOMA,  AFTER SURGICAL THERAPY AND IRRADIATION. ( 1989 – 2006  ;   N = 4.558 )    (Bayes)

6.13. The number of patients with one to >=10 cytological examination according the time interval between the first and last cytological finding.      N=115.471.  1996-2009

6.14. Annual numbers of histopathological FINDINGS (n=232.156)  and FINE NEEDLE ASPIRATION BIOPSY cytological findings (N=159.946) according SNOP localization 1899-2006.

6.15. THE LIST OF TOPOGRAPHIC SITES (SNOP) NOT APPEARING IN 1989 - 2008

6.16. THE LIST OF DIAGNOSES (SNOP) NOT APPEARING IN 1989 - 2008

7. GRAPHICS

      1.- The numbers of histopathological findings according localisation 1989-2009. N=266.886

      2.- The numbers of histopathological findings according SNOP categories.89-2008.N=266.886

3.- The numbers of cytological finding according localisation 1989 – 2008. N = 188.956
      4.- The percentage of positive cytological findings with various degree of certainty (classification

groups III,IV and V) for various localisations. 1989-2009.

5.-  The numbers  of cytological findings according SNOP morphology 89–2008.   N = 188.956

B.--   CLASSIFIED DATA

ANNEX

• Types of histopathological specimens in 2009
• Types of cytological specimens in 2009
• Number of paraffin blocks in 2009
• Number of HP and cytological findings in 2009 and total by institutions
• Workload of pathologists in 2009 and in 1989-2009
• Workdays spent for completion of HP reports in 2009
• Evaluation of clinical diagnoses H , C , CytoN, CytoP
• Examples of crosstabulation for
  • breast crosstabulations
  • breast diagnosis value, Bayes
  • cervix
  • correlations of gynecological cythology with histopathology
    - An example of the monthly comment on the Correlation between Histopathology and     Cytology (February 2004) - Table 1,2,3,4,5
    - An example of the monthly comment on the Correlation between Cytology and Histopathology (February 2004) - Table 6,7,8,9,10,11
  • POSSIBLE IMPACT OF TREATED DYSPLASIAS AND CARCINOMA IN SITU FOUND BY AN OPORTUNISTIC CYTOLOGICAL SCREENING ON CERVICAL INVASIVE CARCINOMA IN MACEDONIA 2004.
  • Differences between definitive arbitrary histopathological diagnosis of cervical intraepithelial carcinoma and previous cytological and biopsy findings. 2005,2006,2007,2008. (N = 624)
  • REALISED DIAGNOSTIC VALUE OF VAGINAL CYTODIAGNOSTIC OF PATIENTS WITH INVASIVE CERVICAL CARCINOMA,  AFTER SURGICAL THERAPY AND IRRADIATION. ( 1989 – 2006  ;   N = 4.558 )
  • The number of patients with one to >=10 cytological examination according the time interval between the first and last cytological finding.      N=115.471.  1996-2009
  • Annual numbers of histopathological and cytological findings according SNOP localization 1899-2008
• The list of topographic sites (SNOP) not appearing in 1989-2009
• The list of diagnoses (SNOP) not appearing in 1989-2009
• Errors

C.- REFFERENCES

D.- ATLAS