OBSERVER RELIABILITY IN ASSESSING PLACENTAL MATURITY BY HISTOLOGY
OBSERVER RELIABILITY IN ASSESSING PLACENTAL MATURITY BY HISTOLOGY
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DOI：
10.1136/jcp.48.5.420
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发表时间：
1995-05-01
影响因子：
3.4
通讯作者：
SHENSCHWARZ, S
中科院分区：
文献类型：
--
作者：
KHONG, TY;STAPLES, A;SHENSCHWARZ, S
目的-为了评估五个有经验的围产期病理学家的能力，以评估胎盘成熟可靠的histologics. Methods-二十四苏木精和伊红幻灯片，6个从胎盘的27，31，35，和39周的妊娠，被分发给五个病理学家在三个不同的场合。这些载玻片被标记上正确或不正确的孕龄。结果所有360个读数的平均绝对误差为2.72周。只有54%的载玻片在正确妊娠的两周内进行了评估。病理学家倾向于高估年轻的妊娠和低估老年妊娠。两个，可能是三个，病理学家受到标签上注明的胎龄的影响。一个病理学家，谁没有出现的标签的影响，是更准确地诊断妊娠的胎盘比其他colleages. Conclusions经验丰富的病理学家可以有困难，评估绒毛成熟的胎盘组织学。它们也可能受到所提供的临床信息的影响，例如胎龄。其他观察员的可靠性研究必须解决的问题，标记的信息对观察员的变化的影响。成熟的差异必须达到六周的量级，才有可能被目前的方法检测到。这可能限制了胎盘发育不良作为子宫胎盘缺血替代标志物的组织学诊断价值。
Aims-To evaluate the ability of five experienced perinatal pathologists to assess placental maturity reliably by histology.Methods-Twenty four haematoxylin and eosin slides, six each from placentas of 27, 31, 35, and 39 weeks' gestation, were circulated to five pathologists on three separate occasions. The slides were labelled with the correct or incorrect gestational ages.Results-The mean absolute error over all 360 readings was 2.72 weeks. Only 54% of the slides were assessed within two weeks of the correct gestation. Pathologists tended to overestimate younger gestations and underestimate older gestations. Two, and possibly three, pathologists were influenced by the gestational age stated on the label. One pathologist, who did not appear to be influenced by the label, was more accurate in diagnosing gestation of the placentas than other colleagues.Conclusions-Experienced pathologists can have difficulty in assessing the villous maturity of placentas by histology. They can also be influenced by clinical information provided, such as gestational age. Other observer reliability studies must address the issue of the influence of labelled information on observer variation. A difference in maturation would have to be of a six week magnitude to have a chance of being detected by current methods. This may limit the value of the histological diagnosis of placental dysmaturity as a surrogate marker for uteroplacental ischaemia.