NEUROPATHOLOGIC DIAGNOSIS OF ALZHEIMER-DISEASE - INTERRATER RELIABILITY IN THE ASSESSMENT OF SENILE PLAQUES AND NEUROFIBRILLARY TANGLES
NEUROPATHOLOGIC DIAGNOSIS OF ALZHEIMER-DISEASE - INTERRATER RELIABILITY IN THE ASSESSMENT OF SENILE PLAQUES AND NEUROFIBRILLARY TANGLES
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DOI：
10.1097/00002093-199307010-00006
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发表时间：
1993-03-01
影响因子：
2.1
通讯作者：
PERLMUTTER, LS
中科院分区：
文献类型：
--
作者：
CHUI, HC;TIERNEY, M;PERLMUTTER, LS
当有进行性痴呆病史并结合新皮质中大量老年斑和神经原纤维缠结的病理结果时，即可诊断为明确的阿尔茨海默病（AD）。然而，最近的研究表明，这些组织病理学病变的定量可能存在显着的人间差异。在目前的两中心研究中，在控制组织学染色和取样的情况下，检查了斑块和缠结计数的受试者间可靠性和重测可靠性。我们报告了 35 例 AD 病例、9 例正常老年对照和 6 例非 AD 痴呆患者的斑块和缠结计数的可靠性水平相似：受试者间可靠性的皮尔逊相关性范围为 0.68 至 0.88，重测可靠性的皮尔逊相关性范围为 0.97 至 0.99。使用定量切点，根据这些病变计数进行 AD 与非 AD 实验诊断的实验室之间的一致性范围为 84% 至 92%（kappa 分数：0.69-0.84）。这些实验诊断与记录的临床病理诊断之间的一致性为 74% 至 86%（kappa 评分：0.50-0.71）。因此，在最佳条件下，AD 的病理诊断可以获得中等至较高程度的受试者间可靠性。
A diagnosis of definite Alzheimer disease (AD) is made when there is a history of progressive dementia combined with the pathologic findings of numerous senile plaques and neurofibrillary tangles in neocortex. Recent studies have shown, however, that there may be significant interrater variability in the quantitation of these histopathologic lesions. In the present two-center study, interrater reliability and test-retest reliability for plaque and tangle counts were examined when histologic staining and sampling were controlled. We report similar levels of reliability for plaque and tangle counts in 35 cases of AD, nine normal elderly controls and six non-AD dementias: Pearson correlations for interrater reliability ranged from 0.68 to 0.88, and from 0.97 to 0.99 for test-retest reliability. Using quantitative cut-points, concordance between laboratories for experimental diagnoses of AD versus non-AD made on the basis of these lesion counts ranged from 84 to 92% (kappa scores: 0.69-0.84). The agreement between these experimental diagnoses and the clinicopathologic diagnoses of record ranged from 74 to 86% (kappa scores: 0.50-0.71). Thus, under optimal conditions, a moderate to substantial degree of interrater reliability can be attained in the pathologic diagnosis of AD.