Weiss system revisited - A clinicopathologic and immunohistochemical study of 49 adrenocortical tumors
Weiss system revisited - A clinicopathologic and immunohistochemical study of 49 adrenocortical tumors
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DOI：
10.1097/00000478-200212000-00009
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发表时间：
2002-12-01
影响因子：
5.6
通讯作者：
Leteurtre, E
中科院分区：
文献类型：
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作者：
Aubert, S;Wacrenier, A;Leteurtre, E
恶性肾上腺皮质肿瘤的明确诊断标准是远处转移和/或局部侵袭。 Weiss 组织病理学系统因其简单性和可靠性而成为评估恶性肿瘤最常用的方法。不幸的是，它的应用仍然是主观的。目前的回顾性研究评估了 Weiss 系统并评估了 MIB-1 标记在诊断肾上腺皮质恶性肿瘤中的价值。选择了 24 例有远处转移、肉眼局部浸润或复发的恶性肿瘤，并将其功能状态与 25 例良性肿瘤相匹配。两位独立观察员描述了韦斯标准。测定MIB-1标记指数。三个或三个以上 Weiss 显微镜标准的存在与恶性肿瘤相关（特异性 96%，敏感性 100%），从而证实了 Weiss 系统的价值。 Weiss 系统（总分）的观察者间一致性非常好（r = 0.94）。由于一些 Weiss 标准缺乏可靠性，我们提出了一个统计修改系统，该系统基于最可靠的标准（2.有丝分裂率 x 2.细胞质 x 异常有丝分裂 x 坏死 x 被膜侵入），与 Weiss 系统显着相关（r = 0.98）。 MIB-1标记指数在恶性肿瘤中显着较高（p
The definitive diagnostic criteria for malignant adrenocortical tumors are distant metastasis and/or local invasion. The Weiss histopathologic system is the most commonly used method for assessing malignancy because of its simplicity and reliability. Unfortunately, its application remains subjective. This current retrospective study evaluated the Weiss system and assessed the value of MIB-1 labeling in the diagnosis of adrenocortical malignancy. Twenty-four malignant tumors with distant metastasis, gross local invasion, or recurrence were selected and matched on their functioning status to 25 benign tumors. Two independent observers delineated the Weiss criteria. An MIB-1 labeling index was determined. Presence of three or more Weiss microscopic criteria was related to malignancy (specificity 96%, sensitivity 100%), thus confirming the value of the Weiss system. Interobserver agreement for the Weiss system (total score) was excellent (r = 0.94). The lack of reliability for some Weiss criteria led us to propose a statistically modified system, based on the most reliable criteria (2.mitotic rate x 2.cytoplasm x abnormal mitoses x necrosis x capsular invasion) with a significant correlation with the Weiss system (r = 0.98). The MIB-1 labeling index was significantly higher in malignant tumors (p