REPRODUCIBILITY AND PROGNOSTIC VALUE OF HISTOLOGIC TYPE AND GRADE IN EARLY EPITHELIAL OVARIAN-CANCER
REPRODUCIBILITY AND PROGNOSTIC VALUE OF HISTOLOGIC TYPE AND GRADE IN EARLY EPITHELIAL OVARIAN-CANCER
复制标题
DOI：
10.1046/j.1525-1438.1993.03020072.x
复制
发表时间：
1993-03-01
影响因子：
4.8
通讯作者：
ANDERSEN, E
中科院分区：
文献类型：
--
作者：
BERTELSEN, K;HOLUND, B;ANDERSEN, E
从1981年9月至1986年9月，丹麦卵巢癌组织(DACOVA)登记了417例连续治疗的上皮性卵巢癌FIGO I期和II期患者。分型和分级主要由几位病理学家进行，有没有接受过妇科病理学方面的培训。一位受过专门训练的病理学家的复习分型显示，浆液性癌和子宫内膜样癌的符合率为72%，粘液性癌的符合率为86%，透明细胞癌的符合率为100%。对接受过妇科病理学培训的病理学家进行初步分类的患者，以及接受过培训和未接受培训的病理学家对患者进行初步分类，计算符合率。接受过专门的妇科病理学培训的病理学家的符合率也不高。根据两种分类进行分级：一种基于建筑模式，另一种基于组合标准。回顾分级显示建筑分类的符合率为77%，综合分类的符合率为52%。在审查时，两个等级分类之间的符合率仅为62%。联合分级显示出将更多的肿瘤归类为低级别的明显趋势。所有分级均有预后价值。即使是由具有妇科病理学专业知识的病理学家进行的类型和分级的符合率也很低，这要求对卵巢恶性肿瘤有更好和更具重复性的特征。
From September 1981 to September 1986, 417 consecutive treated patients with epithelial ovarian cancer FIGO stage I and II were registered by the Danish Ovarian Cancer Group (DACOVA). Typing and grading were primarily performed by several pathologists, with and without training in gynecologic pathology. Review typing by one specially trained pathologist showed an agreement rate of 72% for serous and endometrioid carcinoma, 86% for mucinous and 100% for clear cell carcinoma. The agreement rate was calculated for patients primarily classified by pathologists trained in gynecologic pathology and for patients primarily classified by pathologists with and without training. The agreement rate was not better for the group of pathologists with special training in gynecologic pathology. Grading was performed according to two classifications: one based on architectural pattern and one on combined criteria. Review grading showed an agreement rate of 77% for architectural classification and an agreement rate of 52% for combined classification. The agreement rate between the two grade classifications at review was only 62%. Combined grading showed a significant tendency towards classifying more tumors as low grade. All grade classifications had prognostic value. The poor agreement rate of both type and grade even when performed by pathologists with expertise in gynecologic pathology, calls for a better and more reproducible characterization of malignant ovarian tumors.