Interobserver Agreement Among Pathologists for Semiquantitative Hormone Receptor Scoring in Breast Carcinoma
Interobserver Agreement Among Pathologists for Semiquantitative Hormone Receptor Scoring in Breast Carcinoma
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DOI：
10.1309/ajcp6dkrnd5ckvdd
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发表时间：
2012-12-01
影响因子：
3.5
通讯作者：
Bhargava, Rohit
中科院分区：
文献类型：
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作者：
Cohen, David A.;Dabbs, David J.;Bhargava, Rohit
美国临床肿瘤学会/美国病理学家学会（ASCO/CAP）指南建议以半定量方式报告激素受体检测结果。本研究使用74例切除的雌激素受体（ER）阳性浸润性乳腺癌，以确定激素受体半定量评分的重现性，使用H评分法。4名病理学家对每张切片进行独立评分。通过Fleiss kappa统计对ER和孕激素受体（PR）分类评分进行分析。使用组内相关系数（ICC）来估计连续量表（0-300）上ER和PR H评分的观察者间一致性。分类ER结果的一致性为100%（kappa = 1），分类PR结果的一致性为97%（kappa = 0.823，P <0.001）。对于定量H评分，ER和PR的ICC一致性分别为0.85（95%置信区间[CI] = 0.79-0.90）和0.87（95% CI = 0.82-0.92）。由于H评分提供了肿瘤激素受体含量的连续测量，我们建议普遍采用这种方法。
The American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines recommend reporting of hormone receptor test results in a semiquantitative manner. This study used 74 resected estrogen receptor (ER) positive invasive breast cancers to determine reproducibility of semiquantitative scoring of hormone receptors using the H-score method. Four pathologists independently scored each slide. Agreement among observers was analyzed via Fleiss kappa statistics on ER and progesterone receptor (PR) categorical scores. Intraclass correlation coefficient (ICC) was used to estimate the interobserver agreement for ER and PR H-scores on a continuous scale (0-300). There was 100% agreement for categorical ER results (kappa = 1) and 97% agreement (kappa = 0.823, P < .001) for categorical PR results. For quantitative H-scores, ICC agreement was 0.85 (95% confidence interval [CI] = 0.79-0.90) for ER and 0.87 (95% CI = 0.82-0.92) for PR. Because the H-score provides a continuous measure of tumor hormone receptor content, we suggest universal adoption of this method.