Inter-observer variation between general and specialist gastrointestinal pathologists when grading dysplasia in ulcerative colitis
Inter-observer variation between general and specialist gastrointestinal pathologists when grading dysplasia in ulcerative colitis
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DOI：
10.1002/path.876
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发表时间：
2001-06-01
影响因子：
7.3
通讯作者：
Mayberry, J
中科院分区：
文献类型：
--
作者：
Eaden, J;Abrams, K;Mayberry, J
(UC)最近，病理学家在其他癌症筛查计划方面受到了媒体的不利关注。本研究的目的是通过检查两组之间观察者间的差异来确定结肠活检标本是否应由胃肠道病理学家而不是通才进行检查。将显示不同程度异型增生的51个编码载玻片邮寄给7名胃肠道和6名普通组织病理学家，病理学家将每个活检分为四个类别之一，没有临床病史的好处，也没有机会使用里德尔中包含的“不确定”类别。使用Kappa统计分析响应。胃肠道病理学家的总体kappa统计量为0.30 [95%置信区间（CI）= 0.26-0.34]，普通病理学家为0.28（95% CI=0.23-0.32）。高度异型增生的一致性最好（GI和普通病理学家的kappa值分别为0.54和0.61）。13名病理学家在51张载玻片中仅4张（7.8%）（95% CI=0.4-15.2%）的总体一致性。从这些结果可以得出结论，在对UC的异型增生进行分级时，胃肠道病理学家并不比通才更好，并且两组的一致性较差。因此，没有证据表明，让专业组织病理学中心专门专注于解释来自英国各地的所有监测结肠镜活检会有任何益处，必须向公众明确，监测和筛查程序具有显著的组织学错误率，并且不能期望或实现现有方法的完美，版权所有（C）2001 John Wiley & Sons，Ltd.
(UC), Recently, pathologists have received unfavourable media attention concerning other cancer screening programmes. The aim of this study was to determine whether colonic biopsy specimens should be examined by gastrointestinal pathologists as opposed to generalists, by examining interobserver variation between the two groups, Fifty-one coded slides showing varying degrees of dysplasia were mailed to seven gastrointestinal and six general histopathologists, Pathologists allocated each biopsy into one of four categories without the benefit of a clinical history or an opportunity to use the 'indefinite' category that is included in the Riddell classification, The responses were analysed using kappa statistics. The overall kappa statistic for gastrointestinal pathologists was 0.30 [95% confidence interval (CI)= 0.26-0.34] and for general pathologists 0.28 (95% CI=0.23-0.32). Agreement was best for high-grade dysplasia (kappa of 0.54 and 0.61 for GI and general pathologists, respectively). There was total concordance of the 13 pathologists in only four of the 51 slides (7.8%) (95% CI=0.4-15.2%). It is concluded from these results that gastrointestinal pathologists are no better than generalists when grading dysplasia in UC and that agreement is poor in both groups, There is therefore no evidence that there would be any benefit in having specialist histopathology centres concentrating specifically on the interpretation of all surveillance colonoscopy biopsies from around the UK, It must be made clear to the public that surveillance and screening programmes carry a significant rate of histological error and that perfection cannot be expected or achieved with present methods, Copyright (C) 2001 John Wiley & Sons, Ltd.