Interobserver variability on the histopathologic diagnosis of cutaneous melanoma and other pigmented skin lesions
Interobserver variability on the histopathologic diagnosis of cutaneous melanoma and other pigmented skin lesions
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DOI：
10.1200/jco.1996.14.4.1218
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发表时间：
1996-04-01
影响因子：
45.3
通讯作者：
Faraggiana, T
中科院分区：
文献类型：
--
作者：
Corona, R;Mele, A;Faraggiana, T
目的：评估观察者对皮肤黑色素瘤诊断和分类的一致性。材料和方法：一组140张皮肤黑色素瘤的载玻片，包括一小部分良性色素皮肤病变，分发给四位经验丰富的组织病理学家。使用Fleiss描述的方法计算每个受试者的多个评分的kappa统计量。结果：140例皮肤黑色素瘤与良性病变的kappa值为0.61，有37例（26%）诊断不一致。对于皮肤黑色素瘤的组织学分类，kappa值最高的是Breslow厚度（kappa = 0.76）和溃疡的存在（kappa = 0.87）。其他组织学特征的一致性一般较差，如真皮侵袭水平（kappa = 0.38）、退行性侵（kappa = 0.22）和淋巴细胞浸润（kappa = 0.27）。结论：我们的研究表明病理学家对黑色素瘤与其他色素病变的诊断存在相当大的分歧。肿瘤厚度和溃疡的存在是皮肤黑色素瘤最具重复性的组织学特征。(C)美国临床肿瘤学会1996。
Purpose: To assess the interobserver agreement on the diagnosis and classification of cutaneous melanoma.Materials and Methods: A set of 140 slides of cutaneous melanoma, including a small subset of benign pigmented skin lesions, were circulated to four experienced histopathologists. The kappa statistic for multiple ratings per subject was calculated using the method described by Fleiss.Results: The kappa value on the diagnosis of cutaneous melanoma versus benign lesions was 0.61, There was some discordance on the diagnosis in 37 of 140 cases (26%). For the histologic classification of cutaneous melanoma, the highest kappa values were attained for Breslow thickness (kappa = 0.76) and presence of ulceration (kappa = 0.87). The agreement was generally poor for other histologic features, such as level of dermal invasion (kappa = 0.38), presence of regression (kappa = 0.22), and lymphocytic infiltration (kappa = 0.27).Conclusion: Our study suggests considerable disagreement among pathologists on the diagnosis of melanoma versus other pigmented lesions. Tumor thickness and presence of ulceration are the most reproducible histologic features of cutaneous melanoma. (C) 1996 by American Society of Clinical Oncology.