Grading of Medullary Thyroid Carcinoma: an Interobserver Reproducibility Study
Grading of Medullary Thyroid Carcinoma: an Interobserver Reproducibility Study
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DOI：
10.1007/s12022-022-09718-0
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发表时间：
2022-05-13
影响因子：
4.4
通讯作者：
Barletta, Justine A.
中科院分区：
文献类型：
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作者：
Williams, Jessica F.;Zhao, Melissa;Barletta, Justine A.
基于增殖活性和肿瘤坏死的分级最近在多变量分析中被证明是甲状腺髓样癌（MTC）的预后指标。本研究的目的是评估MTC评估等级的观察者间重现性。三组（每组包括一名居民/研究员和一名主治病理学家）独立评估了44例散发性MTC的队列。对于每例病例，审查所有可用的肿瘤载玻片，并记录有丝分裂计数和肿瘤坏死的存在。进行Ki-67检测，并在最高增殖活性区域测定Ki-67增殖指数。根据最近发表的国际甲状腺髓样癌分级系统（IMTCGS）对肿瘤进行分级。计算每个单独标准（有丝分裂计数、Ki-67增殖指数和坏死）和指定IMTCGS等级的Kappa统计量。对于我们的44例MTC队列，有丝分裂计数、Ki-67增殖指数和坏死的kappa统计值分别为0.68、0.86和0.89。分配的IMTCGS等级的Kappa统计量为0.87。我们的研究结果表明，在我们的MTC队列中，分级评估有很高的一致性，表明IMTCGS评估的分级不仅是预后，而且是可重复的。
Grade, based on proliferative activity and tumor necrosis, has recently been shown to be prognostic in medullary thyroid carcinoma (MTC) in multivariate analysis. The aim of this study was to evaluate the interobserver reproducibility of assessed grade in MTC. Three groups (each group included one resident/fellow and one attending pathologist) independently evaluated a cohort of 44 sporadic MTC. For each case, all available tumor slides were reviewed, and mitotic count and the presence of tumor necrosis were recorded. Ki-67 was performed, and the Ki-67 proliferative index was determined in the area of highest proliferative activity. Tumors were graded according to the recently published International Medullary Thyroid Carcinoma Grading System (IMTCGS). Kappa statistics were calculated for each individual criterion (mitotic count, Ki-67 proliferative index, and necrosis) and for assigned IMTCGS grade. For our cohort of 44 MTCs, the kappa statistic for mitotic count, Ki-67 proliferative index, and necrosis was 0.68, 0.86, and 0.89, respectively. The kappa statistic for assigned IMTCGS grade was 0.87. Our findings indicate that there was a strong level of agreement for assessment of grade in our cohort of MTC, indicating that grade as assessed by the IMTCGS is not only prognostic but also reproducible.