Validation of interobserver agreement in lung cancer assessment: hematoxylin-eosin diagnostic reproducibility for non-small cell lung cancer: the 2004 World Health Organization classification and therapeutically relevant subsets.
Validation of interobserver agreement in lung cancer assessment: hematoxylin-eosin diagnostic reproducibility for non-small cell lung cancer: the 2004 World Health Organization classification and therapeutically relevant subsets.
复制标题
肺癌评估中观察者间一致性的验证：非小细胞肺癌的苏木精 - 欧生诊断性可重复性：2004年世界卫生组织的分类和治疗相关的子集。
DOI：
10.5858/arpa.2012-0033-oa
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发表时间：
2013-01
影响因子：
4.6
通讯作者：
Funkhouser WK
中科院分区：
文献类型：
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作者：
Grilley-Olson JE;Hayes DN;Moore DT;Leslie KO;Wilkerson MD;Qaqish BF;Hayward MC;Cabanski CR;Yin X;Socinski MA;Stinchcombe TE;Thorne LB;Allen TC;Banks PM;Beasley MB;Borczuk AC;Cagle PT;Christensen R;Colby TV;Deblois GG;Elmberger G;Graziano P;Hart CF;Jones KD;Maia DM;Miller CR;Nance KV;Travis WD;Funkhouser WK
基于亚型特异性治疗（如贝伐珠单抗和培美曲塞）的可用性，以及基于活化表皮生长因子受体突变的亚型特异性患病率，非小细胞肺癌的精确亚型诊断越来越重要。建立2004年世界卫生组织分类中苏木精-伊红法诊断非小细胞肺癌的观察者间重现性基线测量，评估治疗相关鳞状/非鳞状亚组的观察者间重现性，并检查改善观察者间重现性的特征。将原发性切除的肺癌标本转换为数字（虚拟）载玻片。根据一个单一的苏木精-伊红虚拟载玻片，病理学家被要求分配使用2004年世界卫生组织分类的诊断。计算每个切片的每个病理学家对的Kappa统计量，并按分类方案、肺病理学专业知识、诊断置信度和肿瘤分级进行总结。12名肺病理学专家和12名社区病理学家各自独立诊断了来自96例非小细胞肺癌切除术的48至96张单苏木精-伊红数字切片。从44个世界卫生组织综合诊断（κ = 0.25）简化为10个主要标题亚型（κ = 0.48）后，总体一致性得到改善，并在简化为治疗相关鳞状/非鳞状二分法（κ = 0.55）后再次改善。多变量分析显示，较高的诊断一致性与较好的分化、较好的切片质量、较高的诊断信心、相似的病理学经验年限和肺部病理学专业知识相关。这些数据定义了苏木精-伊红诊断非小细胞肺癌的基线诊断一致性，允许未来的研究测试反射辅助检查的诊断一致性改善。
Precise subtype diagnosis of non–small cell lung carcinoma is increasingly relevant, based on the availability of subtype-specific therapies, such as bevacizumab and pemetrexed, and based on the subtype-specific prevalence of activating epidermal growth factor receptor mutations. To establish a baseline measure of inter-observer reproducibility for non–small cell lung carcinoma diagnoses with hematoxylin-eosin for the current 2004 World Health Organization classification, to estimate interobserver reproducibility for the therapeutically relevant squamous/nonsquamous subsets, and to examine characteristics that improve interobserver reproducibility. Primary, resected lung cancer specimens were converted to digital (virtual) slides. Based on a single hematoxylin-eosin virtual slide, pathologists were asked to assign a diagnosis using the 2004 World Health Organization classification. Kappa statistics were calculated for each pathologist-pair for each slide and were summarized by classification scheme, pulmonary pathology expertise, diagnostic confidence, and neoplastic grade. The 12 pulmonary pathology experts and the 12 community pathologists each independently diagnosed 48 to 96 single hematoxylin-eosin digital slides derived from 96 cases of non–small cell lung carcinoma resection. Overall agreement improved with simplification from the comprehensive 44 World Health Organization diagnoses (κ = 0.25) to their 10 major header subtypes (κ = 0.48) and improved again with simplification into the therapeutically relevant squamous/nonsquamous dichotomy (κ = 0.55). Multivariate analysis showed that higher diagnostic agreement was associated with better differentiation, better slide quality, higher diagnostic confidence, similar years of pathology experience, and pulmonary pathology expertise. These data define the baseline diagnostic agreement for hematoxylin-eosin diagnosis of non–small cell lung carcinoma, allowing future studies to test for improved diagnostic agreement with reflex ancillary tests.