基于Silva模式的HPV相关的宫内腺癌的分类:一个单一机构对学员和妇科病理学家的一致性研究
Christopher Felicelli1, Steven H Smith1, Brannan Griffin2
1Northwestern University Feinberg School of Medicine, Department of Pathology, Chicago, IL, USA.
Pathology, research and practice
|April 18, 2024
概括
席尔瓦对HPV相关的宫内腺癌的分类显示病理学家和学员中适度的可复制性. 一致性因模式而异,突出显示了对这些瘤的一致性组织学评估的挑战.
科学领域:
- 妇科病理学 妇科病理学
- 在瘤学瘤学.
- 组织病理学 组织病理学
背景情况:
- 基于Silva模式的分类对于评估与HPV相关的宫内腺癌至关重要.
- 之前的研究报告说,Silva系统的复制性是混合的.
- 临床决策通常依赖于FIGO分期而不是Silva分类.
研究的目的:
- 在一个机构的妇科病理学家和实习生中评估Silva分类的观察者间一致性.
- 为了识别具有较低一致率的特定模式.
- 评估一致性可变性的临床影响.
主要方法:
- 对69例HPV相关的宫内腺癌病例进行了回顾性审查.
- 通过10名参与者 (病理学家和实习生) 使用Silva分类进行组织学评估.
- 使用kappa一致性 (κ) 值进行统计分析.
主要成果:
- 在所有参与者中观察到整体中度一致性 (κ=0.439).
- 病理学家一致性 (κ=0.460) 和实习生一致性 (κ=0.417) 都是中度的.
- 完美的一致性很低 (11.6%),根据模式有显著的变化 (模式A:22.7%,模式B:0%,模式C:9.7%).
- 两个A型病例的复发表明,在有限的标本中,可能低估了攻击性.
结论:
- 席尔瓦分类显示了适度的观察者间可重现性,在各种模式中具有显著的变化.
- 持续应用Silva系统需要进一步的标准化和培训,特别是对于实习生.
- 这些发现强调了需要提高HPV相关的宫内腺癌的诊断准确性,以指导最佳的患者管理.
相关概念视频
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