Utility of Pathology Imagebase for standardisation of prostate cancer grading
Utility of Pathology Imagebase for standardisation of prostate cancer grading
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DOI：
10.1111/his.13471
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发表时间：
2018-07-01
期刊：
影响因子：
6.4
通讯作者：
Clements, Mark
中科院分区：
文献类型：
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作者：
Egevad, Lars;Delahunt, Brett;Clements, Mark
尽管努力提高前列腺癌的分级，但即使在专家中，分级实践仍存在相当大的差异。在这项研究中，我们描述了使用的病理图像库，一种新的参考图像库，为设置一个国际标准，前列腺癌grading.Methods和resultsThe国际泌尿病理学会（ISUP）最近推出了一个参考图像数据库的专家监督。一个由24名国际前列腺病理学专家组成的小组独立审查了90例前列腺穿刺活检的显微照片。线性加权kappa值为0.67（95%置信区间= 0.62-0.72），50例病例达成共识。观察者间加权Kappa值为0.48 ~ 0.89。Gleason评分（GS）3 + 3 = 6（ISUP 1级）的一致性最高，而更高级别，特别是GS 4 + 3 = 7（ISUP 3级）显示出相当大的分歧。一旦达到三分之二多数，图像将自动转移到一个公共数据库，供所有ISUP成员使用。非成员能够访问数量有限的cases.ConclusionsIt预计，该数据库将有助于病理学家校准他们的分级，因此，减少观察者之间的变异。它还将有助于查明需要澄清职等定义的情况。
AimsDespite efforts to standardise grading of prostate cancer, even among experts there is still a considerable variation in grading practices. In this study we describe the use of Pathology Imagebase, a novel reference image library, for setting an international standard in prostate cancer grading.Methods and resultsThe International Society of Urological Pathology (ISUP) recently launched a reference image database supervised by experts. A panel of 24 international experts in prostate pathology reviewed independently microphotographs of 90 cases of prostate needle biopsies with cancer. A linear weighted kappa of 0.67 (95% confidence interval = 0.62-0.72) and consensus was reached in 50 cases. The interobserver weighted kappa varied from 0.48 to 0.89. The highest level of agreement was seen for Gleason score (GS) 3 + 3 = 6 (ISUP grade 1), while higher grades and particularly GS 4 + 3 = 7 (ISUP grade 3) showed considerable disagreement. Once a two-thirds majority was reached, images were moved automatically into a public database available for all ISUP members at . Non-members are able to access a limited number of cases.ConclusionsIt is anticipated that the database will assist pathologists to calibrate their grading and, hence, decrease interobserver variability. It will also help to identify instantces where definitions of grades need to be clarified.