An algorithm for the grading of activity in chronic hepatitis C
An algorithm for the grading of activity in chronic hepatitis C
复制标题
DOI：
10.1002/hep.510240201
复制
发表时间：
1996-08-01
期刊：
影响因子：
13.5
通讯作者：
Poynard, T
中科院分区：
文献类型：
--
作者：
Bedossa, P;Poynard, T
组织学活动反映了对基本坏死性炎症病变的全面评估，是慢性丙型肝炎的重要标准。本研究的目的是提出并测试一种基于基本病理特征生成单一活动恐慌的简单算法的准确性。由10名病理学家组成的小组回顾了363例慢性丙型肝炎肝活检组织，并根据自己的经验(参考活动)对肝炎活动进行分级，然后，由10名专家在小组讨论中建立了关于活动分级的共识算法，最后进行逐步判别分析，以确定参考活动(统计活动)中直观地使用了哪些基本特征，以测试该算法的准确性，对算法定义的活性和参考活性之间的一致性进行了评估。将统计模型定义的活动与参考活动进行一致性比较。专家小组提出的活动性分级算法包括片状坏死和小叶坏死，参考活动性与算法定义的活动性的一致性很高(305例，84%，kappa=0.75)，判别分析显示，片状坏死、小叶坏死和门脉炎症独立用于活动性分级，参考活动性与统计模型定义的活动性之间的符合性很大(300例，83%，kappa=0.73)，与算法定义的活动性的一致性基本相同。本研究提出了一种简单的慢性肝炎活动性分级的算法，其准确率与统计方法得到的结果一样高。
Histological activity reflects the global assessment of basic necroinflammatory lesions and is a criterion of major importance in chronic hepatitis C, The aim of this study was to propose and test the accuracy of a simple algorithm that generates a single activity scare based on basic pathological features, A panel of 10 pathologists reviewed 363 chronic hepatitis C liver biopsies and graded the activity of hepatitis according to their own experience (reference activity), Then, a consensual algorithm on the grading of activity was established by the 10 experts in a panel discussion, Finally, stepwise discriminant analysis was performed to define which basic features had been intuitively used in the reference activity (statistical activity), To test the accuracy of the algorithm, concordance between the activity defined by the algorithm and the reference activity was assessed. It was compared with concordance between the activity defined by the statistical model and the reference activity. The algorithm proposed by the panel for the grading of activity included piecemeal necrosis and lobular necrosis, Concordance between reference activity and activity defined by the algorithm was substantial (305 cases, 84%, kappa = .75), Discriminant analysis showed that piecemeal necrosis, lobular necrosis, and portal inflammation were independently used to grade the activity, Concordance between reference activity and activity defined by the statistical model was substantial (300 cases, 83%, kappa = .73), virtually identical to the concordance between reference activity and activity defined by algorithm, This study proposes a simple algorithm for the grading of activity in chronic hepatitis, Its accuracy is as high as that obtained using a statistical approach.