Reproducibility of Histologic Classification in Nonfibrotic Myeloproliferative Neoplasia
Reproducibility of Histologic Classification in Nonfibrotic Myeloproliferative Neoplasia
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DOI：
10.1309/ajcp2ug9sggwahua
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发表时间：
2011-10-01
影响因子：
3.5
通讯作者：
Hebeda, Konnie M.
中科院分区：
文献类型：
--
作者：
Koopmans, Suzanne M.;Bot, Freek J.;Hebeda, Konnie M.
真性红细胞增多症、原发性血小板增多症和原发性骨髓纤维化（PMF）的早期阶段仅通过形态学研究可能难以区分，因为它们具有许多形态学特征。根据2008年世界卫生组织（WHO）分类的组织学标准是骨髓增殖性肿瘤（MPN）诊断的一部分。我们的目的是评估形态学特征的可重复性，并确定它们在所选骨髓活检切片的组织学诊断中的相对重要性。在这项研究中，4名血液病理学家使用WHO分类中提到的16种组织学特征的评分清单，对56例纤维化前MPN骨髓标本进行了盲法评估。共识定义为4名血液病理学家中的3名达成一致。对于WHO分类中使用的各个主要形态学特征，尤其是巨核细胞的核特征（83%），达成了高度共识。一些特征与PMF的组织学诊断呈正相关或负相关。在不了解临床数据的情况下，56例病例中有39例（70%）就MPN的组织学分类达成了共识。这一发现表明不同血液病理学家对各个组织学特征赋予的相对重要性存在差异。
Early phases of polycythemia vera, essential thrombocythemia, and primary myelofibrosis (PMF) can be difficult to distinguish by morphologic studies alone because they share many morphologic characteristics. Histologic criteria according to the 2008 World Health Organization (WHO) classification are part of the myeloproliferative neoplasia (MPN) diagnosis. Our aim was to assess the reproducibility of morphologic characteristics and determine their relative importance for histologic diagnoses on selected trephine biopsy sections.For the study, 56 prefibrotic MPN trephine specimens were blindly reviewed by 4 hematopathologists using a scoring list of 16 histologic characteristics mentioned in the WHO classification. Consensus was defined as agreement by 3 of 4 hematopathologists.High degrees of consensus were reached for individual major morphologic features used in the WHO classification, especially for the nuclear features of megakaryocytes (83%). Some of the features correlated positively or negatively with the histologic diagnosis of PMF. Consensus for the histologic classification of MPN was reached in 39 (70%) of 56 cases without knowledge of clinical data. This finding indicates a difference in the relative importance assigned to individual histologic characteristics by different hematopathologists.