HISTOLOGICAL GRADING IN BREAST-CANCER - INTEROBSERVER AGREEMENT, AND RELATION TO OTHER PROGNOSTIC FACTORS INCLUDING PLOIDY
HISTOLOGICAL GRADING IN BREAST-CANCER - INTEROBSERVER AGREEMENT, AND RELATION TO OTHER PROGNOSTIC FACTORS INCLUDING PLOIDY
复制标题
DOI：
10.3109/00313029209063625
复制
发表时间：
1992-04-01
期刊：
影响因子：
4.5
通讯作者：
STERRETT, GF
中科院分区：
文献类型：
--
作者：
HARVEY, JM;DEKLERK, NH;STERRETT, GF
76例女性原发性可手术乳腺癌患者的肿瘤切片由2名病理学家独立评估组织学特征并进行分级评分。使用对数线性模型估计病理学家之间的相对分歧率，发现与许多其他组报告的相似，但高于公认专家报告的。肿瘤分级与细胞核DNA含量相关，与雌激素受体状态呈负相关，并提供了一些额外的预后信息，但在这一小部分患者中，与其他预后指标如倍性、肿瘤大小或淋巴结受累程度密切相关，与短期生存率无关。III级肿瘤患者的预后特别差，然而，很少有患者被分配到III级（低分化肿瘤），并且I级和II级之间的生存差异很小;在短期随访中，单独使用，分级仅将一小部分患者分为有用的预后组。这项初步研究强调，在乳腺癌的分级中，常规组织病理学实验室。在我们的分级被纳入对患者管理有用的预后指数之前，需要证明观察者之间的一致性或与该领域专家的一致性。
Sections of neoplasms from 76 female patients with primary operable carcinoma of the breast were independently assessed by 2 pathologists for histological features and assigned a grade score. Relative disagreement rates between pathologists were estimated by use of a log-linear model and found to be similar to those reported by many other groups, but higher than that reported by acknowledged experts. Tumor grade was related to nuclear DNA content as measured by static cytometry, inversely related to oestrogen receptor status and provided some additional prognostic information but, in this small series of patients, did not correlate with short-term survival as closely as other prognostic indicators such as ploidy, tumor size or the extent of lymph node involvement. Patients with Grade III tumors had a particularly poor prognosis, however, there were few patients allotted to Grade III (poorly differentiated tumors), and survival differences between Grades I and II were small; in short-term followup, used alone, grading separated out only a small proportion of patients into useful prognostic groups.This preliminary study emphasizes the need for a careful approach to the use of grading of breast carcinomas in the routine histopathology laboratory. Demonstration of higher levels of interobserver agreement, or concordance with experts in the field, will be necessary before our grading can be incorporated into a prognostic index useful for patient management.