Nuclear grade and comedo necrosis of ductal carcinoma in situ as histopathological eligible criteria for the Japan Clinical Oncology Group 1505 trial: an interobserver agreement study
Nuclear grade and comedo necrosis of ductal carcinoma in situ as histopathological eligible criteria for the Japan Clinical Oncology Group 1505 trial: an interobserver agreement study
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导管原位癌的核分级和粉刺坏死作为日本临床肿瘤学组 1505 试验的组织病理学合格标准：观察者间一致性研究
DOI：
10.1093/jjco/hyaa235
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发表时间：
2021
影响因子：
2.4
通讯作者：
Iwata H
中科院分区：
文献类型：
--
作者：
Tsuda H;Yoshida M;Akiyama F;Ohi Y;Kinowaki K;Kumaki N;Kondo Y;Saito A;Sasaki E;Nishimura R;Fujii S;Homma K;Horii R;Murata Y;Itami M;Kajita S;Kato H;Kurosumi M;Sakatani T;Shimizu S;Taniguchi K;Tamiya S;Nakamura H;Kanbayashi C;Shien T;Iwata H
日本临床肿瘤学组1505试验是一项单臂多中心前瞻性研究，旨在研究内分泌治疗对低度导管原位癌患者进行非手术随访的可能性。在该研究中，合格标准包括组织病理学结果，包括低至中等核等级和无粉刺坏死，并根据当地组织病理学诊断入选病例。核分级主要基于共识会议标准（1997），而粉刺坏死根据罗森标准（2017）判断。本研究的目的是标准化和检查interobserver协议水平，这些组织病理学标准之间的参与pathologists.MethodsWe举行幻灯片会议，在显微照片的苏木精-伊红染色的幻灯片从68例导管癌的情况下，使用PowerPoint。核等级和粉刺坏死状态分别判断的病理学家进行了分析，使用κ statistics.ResultsIn第一和第二届会议，其中每22例，观察者之间的协议水平的核等级是否低/中级或高级之间的29和24参与病理学家，分别为中度（κ = 0.595和0.519，分别）。在第三次会议上，24例病例，观察者之间的协议水平粉刺坏死或非粉刺坏死是相当大的25名参与病理学家结论虽然在少数病例中核分级或粉刺样坏死的符合率不高，我们认为这些结果可以为在导管原位癌的临床研究中采用核分级和粉刺样坏死的现有标准提供理论依据。
ObjectiveThe Japan Clinical Oncology Group 1505 trial is a single-arm multicentre prospective study that examined the possibility of non-surgical follow-up with endocrine therapy for patients with low-grade ductal carcinomain situ. In that study, the eligible criteria included histopathological findings comprising low to intermediate nuclear grade and absence of comedo necrosis, and cases were entered according to the local histopathological diagnosis. Nuclear grade is largely based on the Consensus Conference criteria (1997), whereas comedo necrosis is judged according to the Rosen’s criteria (2017). The purpose of this study was to standardize and examine the interobserver agreement levels of these histopathological criteria amongst the participating pathologists.MethodsWe held slide conferences, where photomicrographs of haematoxylin–eosin-stained slides from 68 patients with ductal carcinomain situwere presented using PowerPoint. The nuclear grade and comedo necrosis statuses individually judged by the pathologists were analysed using κ statistics.ResultsIn the first and second sessions, where 22 cases each were presented, the interobserver agreement levels of nuclear grade whether low/intermediate grade or high grade were moderate amongst 29 and 24 participating pathologists, respectively (κ = 0.595 and 0.519, respectively). In the third session where 24 cases were presented, interobserver agreement levels of comedo necrosis or non-comedo necrosis were substantial amongst 25 participating pathologists (κ = 0.753).ConclusionAlthough the concordance rates in nuclear grade or comedo necrosis were not high in a few of the cases, we believe that these results could provide a rationale for employing the present criteria of nuclear grade and comedo necrosis in the clinical study of ductal carcinomain situ.