Histological features associated with diagnostic agreement in atypical ductal hyperplasia of the breast: illustrative cases from the B-Path study.
Histological features associated with diagnostic agreement in atypical ductal hyperplasia of the breast: illustrative cases from the B-Path study.
复制标题
与乳房非典型导管增生的诊断一致性相关的组织学特征：B-Path 研究的说明性病例。
DOI：
10.1111/his.13035
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发表时间：
2016
期刊：
影响因子：
6.4
通讯作者：
Weaver,DonaldL
中科院分区：
文献类型：
--
作者：
Allison,KimberlyH;Rendi,MaraH;Peacock,Sue;Morgan,Tom;Elmore,JoannG;Weaver,DonaldL
AimsThis study examined the case‐specific characteristics associated with interobserver diagnosis agreement in atypical ductal hyperplasia（ADH）of the breast.Methods and resultsSeventy‐ 2 test set cases with a consensus diagnosis of ADH from the B‐Path study were evaluated.对病例的17个组织学特征进行评分，然后将其与参与者对ADH诊断的一致性进行相关分析。还检查了参与病理学家对病例难度、边缘特征或他们是否会获得第二意见的看法是否与同意有关。在2070名参与者对72例ADH共识病例的解释中，48%被参与者评分为困难，45%为两种诊断之间的边界;这两种特征的存在与增加的一致性显著相关（P< 0.001）。在80%的解释中会获得第二意见，这与增加一致性有关（P< 0.001）。诊断一致性范围为10%至89%，具体取决于具体情况。乳头状病变、筛状结构和明显细胞学单调的病例与较高的一致性相关。较低的协议率与固体或微乳头状架构，边界细胞学单调，或没有一个诊断领域，这是明显的低power.ConclusionsThe研究结果表明，病理学家经常认识到ADH的情况下，挑战，一些情况下更容易诊断变异。此外，有特定的组织学特征与ADH病例的诊断一致性相关。本测试集提供了多个案例的示例图像，以作为这些挑战的教育说明。
AimsThis study examined the case‐specific characteristics associated with interobserver diagnostic agreement in atypical ductal hyperplasia (ADH) of the breast.Methods and resultsSeventy‐two test set cases with a consensus diagnosis of ADH from the B‐Path study were evaluated. Cases were scored for 17 histological features, which were then correlated with the participant agreement with the consensus ADH diagnosis. Participating pathologists’ perceptions of case difficulty, borderline features or whether they would obtain a second opinion were also examined for associations with agreement. Of the 2070 participant interpretations of the 72 consensus ADH cases, 48% were scored by participants as difficult and 45% as borderline between two diagnoses; the presence of both of these features was significantly associated with increased agreement (P< 0.001). A second opinion would have been obtained in 80% of interpretations, and this was associated with increased agreement (P< 0.001). Diagnostic agreement ranged from 10% to 89% on a case‐by‐case basis. Cases with papillary lesions, cribriform architecture and obvious cytological monotony were associated with higher agreement. Lower agreement rates were associated with solid or micropapillary architecture, borderline cytological monotony, or cases without a diagnostic area that was obvious on low power.ConclusionsThe results of this study suggest that pathologists frequently recognize the challenge of ADH cases, with some cases being more prone to diagnostic variability. In addition, there are specific histological features associated with diagnostic agreement on ADH cases. Multiple example images from cases in this test set are provided to serve as educational illustrations of these challenges.