Changes in cancer registry coding for lymphoma subtypes: Reliability over time and relevance for surveillance and study
Changes in cancer registry coding for lymphoma subtypes: Reliability over time and relevance for surveillance and study
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DOI：
10.1158/1055-9965.epi-05-0549
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发表时间：
2006-04-01
影响因子：
3.8
通讯作者：
Holly, EA
中科院分区：
文献类型：
--
作者：
Clarke, CA;Undurraga, DM;Holly, EA
由于淋巴瘤包含多种组织学亚型，了解其发病率持续增加的原因需要对这些亚型进行监测和病因学研究。然而，这项研究受到许多共存的分类方案的阻碍。修订后的欧美淋巴肿瘤分类 (REAL)/WHO 系统于 1994 年开发，目前用于临床，但直到 2001 年发布第三版 (ICD-O-3) 才被纳入癌症登记处使用的国际疾病肿瘤分类 (ICD-O)。包括 2001 年之前诊断的患者在内的研究可能具有早期 ICD-O 版本的代码，必须转换为 ICD-O-3 和未分类（例如淋巴瘤和未另行指定）病例的比例较高。为了更好地理解 (a) 计算机转换的 ICD-O-3 代码与直接从诊断病理学报告生成的 ICD-O-3 代码的一致性以及未分类状态的可重复性，我们回顾了 REAL/WHO 计划之前（1988-1994 年；n = 1,493）和之后（1998-2000；n = 1,527）诊断的淋巴瘤患者的基于人群的一系列诊断病理学报告。介绍了。总体而言，计算机和编码器分配的 ICD-O-3 代码对于两组患者中 77% 的患者一致，并且在代码分组后略有改善 (82%)。最常见的淋巴瘤亚型，弥漫性大 B 细胞和滤泡性，在整个研究期间具有相对较好的可靠性 (84-89%)。即使分组时，T 细胞淋巴瘤和自然杀伤细胞淋巴瘤的一致性也比 B 细胞淋巴瘤差。许多（42-43%）报告为无法分类的淋巴瘤可以在病理报告审查后指定为亚型。这些发现表明，淋巴瘤亚型的研究可以通过以下方式得到改进：(a) 在病理报告中使用更标准化的术语，(b) 对各个 ICD-O-3 代码进行分组以减少错误分类偏差，以及 (c) 中央癌症登记处对未分类的淋巴瘤进行常规二次编辑。
Because lymphoma comprises numerous histologic subtypes, understanding the reasons for ongoing increases in its incidence requires surveillance and etiologic study of these subtypes. However, this research has been hindered by many coexisting classification schemes. The Revised European American classification of Lymphoid Neoplasms (REAL)/WHO system developed in 1994 and now used in clinical settings was not incorporated into the International Classification of Diseases-Oncology (ICD-O), used by cancer registries, until the release of the third edition (ICD-O-3) in 2001. Studies including patients diagnosed before 2001 may have codes from earlier ICD-O versions that must be converted to ICD-O-3 and have higher proportions of unclassified (e.g., lymphoma and not otherwise specified) cases. To better understand (a) the agreement of computer-converted ICD-O-3 codes to ICD-O-3 codes generated directly from diagnostic pathology reports and W the reproducibility of unclassified status, we reviewed a population-based series of diagnostic pathology reports for lymphoma patients diagnosed before (1988-1994; n = 1,493) and after (1998-2000; n = 1,527) the REAL/ WHO scheme was introduced. Overall, computer- and coder-assigned ICD-O-3 codes agreed for 77% of patients in both groups and improved slightly (82%) when codes were grouped. The most common lymphoma subtypes, diffuse large B cell and follicular, had relatively good reliability (84-89%) throughout the study period. T-cell and natural killer cell lymphomas had worse agreement than B-cell lymphomas, even when grouped. Many (42-43%) lymphomas reported as unclassifiable could be assigned a subtype upon pathology report review. These findings suggest that the study of lymphoma subtypes could be improved by (a) use of more standardized terminology in pathology reports, (b) grouping individual ICD-O-3 codes to reduce misclassification bias, and (c) routine secondary editing of unclassified lymphomas by central cancer registries.