International standardization project for the clinico-pathological diagnosis of IgA Nephropathy : Development of pathology database with clinical correlations

1. 《IgA肾病临床病理分类修订计划（日本厚生劳动省/日本肾脏学会第3版）》我们设计了一种将临床病理信息汇编成数据库的方法，并综述了如何将该数据库应用于组织学分类。经伦理委员会批准，从13所大学医院和21所国家医院组织肾网机构收集IgA肾病（IgAN）肾活检材料643例（成人529例，儿童114例）。统计分析未接受类固醇治疗的患者（非ST组）IgAN对蛋白尿进展（PUP）和肾功能损害（RFI）的组织学损害的危险因素，并将非ST组与接受ST组（ST组）的数据进行比较，以阐明获得ST有效性的组织学病变。此外，还建立了预测预后概率的方程，通过方程可以判断ST对每个患者的适用性。IgA肾病国际共识分类活动计划与全球14位肾病学家和13位肾脏病理学家合作，实现IgAN病理诊断的国际标准化。收集了来自北美、亚洲和欧洲的300例肾活检资料（成人250例，儿童50例）。我们分别对他们进行诊断，并使用通用计分表进行定量组织病理学诊断的可重复性。我们正在通过积累的病理和临床资料的验证，对分类提出一个原创的建议。

1. Revision plan of the clinico-pathological classification of IgA Nephropathy (3 rd edition by Ministry of Health, Labour and Welfare / Japanese society of Nephrology)We devised a method to compile clinico-pathological information into a database and reviewed how we can apply the database to histological classification. After having got approval of an ethic committee, 643 cases of kidney biopsy material of IgA nephropathy (IgAN) (adult 529 cases, child 114 cases) were collected from 13 university hospital and 21 kidney network institutions of National Hospital Organization. The risk factors in the histological lesions of IgAN for proteinuric progression (PUP) as well as renal functional impairment (RFI) in the patients without steroid therapy (non-ST group) was analyzed statistically, and compared the data of non-ST group with those of the group with ST (ST group), so that the histological lesions getting the effectiveness of ST could be elucidated. In addition, equations predicting probability of the prognoses was produced, by which an applicability of ST for each patient could be judged.2. Activity for an international consensus classification for IgA nephropathyA collaboration with 14 nephrologists and 13 renal pathologists in the world was planed for an international standardization of pathological diagnosis of IgAN. Kidney biopsy materials of 300 cases (adult 250 cases, child 50 cases) were collected from North America, Asia, and Europe. We diagnosed them individually and gave a reproducibility of the quantitative histopathological diagnosis using a common score sheet. We are making an original proposal about the classification by verification with accumulated pathological and clinical data.