Interobserver reproducibility of Gleason grading of prostatic carcinoma: General pathologists
Interobserver reproducibility of Gleason grading of prostatic carcinoma: General pathologists
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DOI：
10.1053/hupa.2001.21135
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发表时间：
2001-01-01
期刊：
影响因子：
3.3
通讯作者：
Epstein, JI
中科院分区：
文献类型：
--
作者：
Allsbrook, WC;Mangold, KA;Epstein, JI
只有少数关于前列腺癌Gleason分级的观察者间重复性的大型研究。将38例含有前列腺癌的活检样本分发给格鲁吉亚的41名普通病理学家进行Gleason分级。这些病例的Gleason分级组（2-4、5-6、7和8-10）得到至少7/10名泌尿病理学家的一致同意。这38例病例的观察者间一致性的总体kappa（kappa）系数为0.435，仅为中度一致性，kappa范围为0.00至0.88。Gleason评分5-6分（47%）、7分（47%）和8-10分（25%）（程度较轻）的一致性降级。在主要模式一致的病例中，模式2（32%）、3（39%）和5（30%）的分级一致降低。模式2经常（17%）被误认为模式3。模式4经常被低估（21%），也被误认为模式5（17%）。与观察者间更好的一致性相关的最显著（P <0.005）的人口统计学因素是在会议或课程中学习过Gleason分级。我们相信，格里森分级可以被学习到一个令人满意的观察者间重现性水平，并已进行了额外的研究，以支持这一版权（C）2001年由W.B.桑德斯公司
Only a few large studies of interobserver reproducibility of Gleason grading of prostatic carcinoma exist. Thirty-eight biopsies containing prostate cancer were distributed for Gleason grading to 41 general pathologists in Georgia. These cases had "consensus" Gleason grade groups (2-4, 5-6, 7, and 8-10) that were agreed on by at least 7 of 10 urologic pathologists. The overall kappa (kappa) coefficient for interobserver agreement for these 38 cases was 0.435, barely moderate agreement, with a kappa range from 0.00 to 0.88. There was consistent undergrading of Gleason scores 5-6 (47%), 7 (47%) and, to a lesser extent, 8-10 (25%). In cases with consensus primary patterns, there was consistent undergrading of patterns 2 (32%), 3 (39%), and 5 (30%). Pattern 2 was often (17%) mistaken for pattern 3. Pattern 4 was often undergraded (21%) and also mistaken for pattern 5 (17%). The most significant (P < .005) demographic factor associated with better interobserver agreement was having learned Gleason grading at a meeting or course. We believe that Gleason grading can be learned to a satisfactory level of interobserver reproducibility and have undertaken additional studies that support this Copyright (C) 2001 by W.B. Saunders Company.