The reproducibility of a binary tumor grading system for uterine endometrial endometrioid carcinoma, compared with FIGO system and nuclear grading
The reproducibility of a binary tumor grading system for uterine endometrial endometrioid carcinoma, compared with FIGO system and nuclear grading
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DOI：
10.1159/000082917
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发表时间：
2004-01-01
期刊：
影响因子：
3.5
通讯作者：
Kudo, R
中科院分区：
文献类型：
--
作者：
Sagae, S;Saito, T;Kudo, R
目的：已经提出了一个二元分级系统来评估实体生长的量、浸润的模式和坏死的存在，从而将子宫内膜类腺瘤分为低级别和高级别肿瘤。我们分析了这个系统的预测预后，观察者之间和观察者内的可重复性和治疗方式。研究方法：共200例子宫内膜癌，子宫切除标本的基础上，根据二元分级系统进行分级，与国际妇产科联合会（FIGO）系统和核分级进行比较。结果如下：与FIGO系统（0.50; 60%和0.62; 73%）和核分级（0.23; 49%和0.43; 65%）相比，使用二元分级系统的观察者间和观察者内一致性（kappa = 0.57;一致性百分比：82%和kappa = 0.62; 84%）均为上级。早期低级别肿瘤患者的5年生存率（5YS）为98%。早期高级别肿瘤患者和晚期低级别肿瘤患者的5年生存率分别为86%至87%。但晚期高级别肿瘤患者的5年生存率为49%。在二元低级别早期肿瘤中，与其他治疗相比，不使用辅助治疗和化疗的患者结局更好。总结：二进制分级系统是优于其他允许更大的重复性和预测子宫内膜癌患者的预后上级。版权所有（C）2004 S. Karger AG，巴塞尔。
Objective: A binary grading system has been proposed to assess the amount of solid growth, the pattern of invasion, and the presence of necrosis, and thereby divide endometrial endometrioid carcinomas into low- and high-grade tumors. We analyzed this system for predicting the prognosis, with respect to inter- and intraobserver reproducibility and treatment modalities. Methods: A total of 200 endometrial carcinomas, based on hysterectomy specimens, were graded according to the binary grading system, for comparison against The International Federation of Gynecology and Obstetrics (FIGO) system and nuclear grading. Results: Both inter- and intraobserver agreement using the binary grading system (kappa = 0.57; percent agreement: 82% and kappa = 0.62; 84%) were superior compared with the FIGO system (0.50; 60% and 0.62; 73%) and the nuclear grading (0.23; 49% and 0.43; 65%). Patients with early-stage low- grade tumors had a 98% rate for 5-year survival (5YS). Patients with early-stage high-grade tumors, and those with advanced-stage low-grade tumors, had respectively 86% to 87% rates for 5YS. But patients with advanced-stage high-grade tumors had a 49% rate for 5YS. In binary low-grade early-stage tumors, the patient outcome was better with no adjuvant therapy and chemotherapy, compared with other therapies. Conclusion: A binary grading system was superior to others in permitting greater reproducibility and predicting the prognosis of endometrial cancer patients. Copyright (C) 2004 S. Karger AG, Basel.