The accuracy of meningioma grading: a 10-year retrospective audit
The accuracy of meningioma grading: a 10-year retrospective audit
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DOI：
10.1111/j.1365-2990.2004.00621.x
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发表时间：
2005-04-01
影响因子：
5
通讯作者：
Everington, D
中科院分区：
文献类型：
--
作者：
Willis, J;Smith, C;Everington, D
Although descriptive classifications of meningioma subtypes are well established, there has been inconsistency in the categorization of meningiomas into benign, atypical and anaplastic groups.本研究的目的是应用世界卫生组织 (WHO) 2000 年分类系统重新评估 10 年内非典型（II 级）脑膜瘤的发病率。第二个目标是确定 II 级和 III 级肿瘤是否变得更加常见。从爱丁堡西部综合医院神经病理科的档案中检索到 1994 年至 2003 年间切除的 314 个脑膜瘤切片。使用 WHO 2000 分类系统对它们进行重新评估和分级。审稿人对最初的分类和分级一无所知。十年来，每年切除的脑膜瘤数量逐渐增加。重新分类时，78%的脑膜瘤被分类为I级，20.4%被分类为II级，1.6%被分类为III级。对于使用WHO 2000年分类系统分类的II级脑膜瘤，38.1%在2000年之前最初被分类为I级，而13.6%在2000年后最初被分类为I级。在大多数情况下，重新分类是由于正式计数核分裂数。在当前的世界卫生组织分类系统下，非典型脑膜瘤的诊断频率高于以前的分类系统。尽管目前的 WHO (2000) 分类比以前的分类更具规范性，但由于某些标准的主观性，观察者之间的差异可能仍然存在。
Although descriptive classifications of meningioma subtypes are well established, there has been inconsistency in the categorization of meningiomas into benign, atypical and anaplastic groups. The aim of this study was to reassess the incidence of atypical (grade II) meningiomas over a 10-year period by applying the World Health Organization (WHO) 2000 classification system. A secondary aim was to determine if grade II and III tumours were becoming more common. Sections of 314 meningiomas resected between 1994 and 2003 were retrieved from the archives of the Western General Hospital's neuropathology unit in Edinburgh. They were reassessed and graded by using the WHO 2000 classification system. The reviewers were blind to the original classification and grading. There was a gradual increase in the numbers of meningiomas being resected annually over the 10-year period. On reclassification, 78% of the meningiomas were classified as grade I, 20.4% as grade II and 1.6% as grade III. With regard to grade II meningiomas classified by using the WHO 2000 classification system, 38.1% had originally been classified as grade I prior to 2000, whereas 13.6% had originally been classified as grade I after 2000. In most cases, reclassification was due to formal counts of mitotic figures. Atypical meningiomas are diagnosed more frequently under the current WHO classification system than they were under the previous classification systems. Although the current WHO (2000) classification is more prescriptive than its predecessors, interobserver variability is likely to remain because of the subjective nature of some of the criteria.