Interobserver and intraobserver reproducibility in the histopathology of follicular thyroid carcinoma
Interobserver and intraobserver reproducibility in the histopathology of follicular thyroid carcinoma
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DOI：
10.1016/s0046-8177(03)00403-9
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发表时间：
2003-11-01
期刊：
影响因子：
3.3
通讯作者：
Chastang, C
中科院分区：
文献类型：
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作者：
Franc, B;De la Salmonière, P;Chastang, C
我们评估了滤泡性甲状腺癌（FTC）组织病理学的观察者间和观察者内的可重复性。41张匿名FTC病理切片由5位病理学家独立审阅，其中31张还由同一位病理学家进行两次评估。最终共识诊断（FCD）在研究结束时作出。定性数据的kappa统计量和定量数据的类内相关系数分别为观察者间和观察者内一致性。5名观察员的初步诊断与FCD的一致性分别为0.69、0.41、0.35、0.28和0.11，强烈提示存在领导现象。FCD将30例诊断为恶性，其中24例诊断为FTC。24个联邦贸易委员会中有13个达成了一致意见。发现非微创FTC的诊断可重复性是可接受的。在FCD分类为微创性FrC的7例中，有57%的病例诊断不一致。FCD排除恶性肿瘤1例，包括6例非典型腺瘤。观察者间和观察者内对FTC诊断的一致性分别为0.23（标准误差[SE]， 0.04）和0.68。对于血管侵犯的存在，观察者之间和观察者内部的一致性分别为0.20 （SE, 0.04）和0.51，而在考虑血管侵犯的数量时，一致性为中等至实质性水平。观察者之间和观察者内部对核光学清除的一致性分别为轻微和中等。该研究的重要性在于确认了微创FTC的诊断可重复性较低，这具有临床意义，也对FTC的治疗和结果的研究设计具有意义。(C) 2003 Elsevier Inc.版权所有。
We evaluated the interobserver and intraobserver reproducibility in the histopathology of follicular thyroid carcinoma (FTC). Forty-one anonymous FTC pathology slides were independently reviewed by 5 pathologists, and 31 of them were also evaluated twice by the same pathologist. A final consensus diagnosis (FCD) was made at the end of the study. Interobserver and intraobserver agreement was determined as the kappa statistic for qualitative data and intraclass correlation coefficient for quantitative data. The agreement between the 5 observers' initial diagnosis and the FCD was 0.69, 0.41, 0.35, 0.28 and 0.11, respectively, strongly suggesting a leadership phenomenon. The FCD classified 30 cases as malignant, including 24 cases diagnosed as FTC. There was unanimous agreement about 13 of the 24 FTCs. Diagnostic reproducibility was found to be acceptable for the nonminimally invasive FTC. Diagnostic discrepancies occurred in 57% of the seven cases classified as minimally invasive FrC by the FCD. FCD excluded malignancy in I I cases including 6 atypical adenomas. Interobserver and intraobserver agreement for FTC diagnosis was 0.23 (standard error [SE], 0.04) and 0.68, respectively. Interobserver and intraobserver agreement for the presence of vascular invasion was 0.20 (SE, 0.04) and 0.51, respectively, contrasting with a moderate to substantial level of agreement when considering the number of vascular invasion. Interobserver and intraobserver agreement for nucleus optical clearing were slight and moderate, respectively. The importance of the study is the confirmation that diagnostic reproducibility of minimally invasive FTC is low and that this has clinical implications, and also implications for the design of studies into the treatment and outcome of FTC. (C) 2003 Elsevier Inc. All rights reserved.