评估妇科病理学家之间的观察者间协议 基于HPV相关的宫内腺癌的三级对二进制模式分类系统
Roman E Zyla1,2, David W Dodington1,2, Sara Pakbaz1,3
1Department of Laboratory Medicine and Pathobiology, University of Toronto.
The American journal of surgical pathology
|July 17, 2024
概括
人类乳头瘤病毒 (HPV) 相关的宫内腺癌 (EA) 的新二进制分类系统显示,与传统的三层系统相比,观察者之间的协议得到了改善. 这种二进制系统可能会增强淋巴结参与和复发的风险分层.
科学领域:
- 妇科病理学 妇科病理学
- 癌症分类 癌症分类
- 在瘤学瘤学.
背景情况:
- 三层席尔瓦分类系统预测了淋巴结参与和复发的人类乳头瘤病毒 (HPV) 相关的宫内腺癌 (EA).
- 为了提高预后意义,提出了一种新型的二进制分类系统,其中包括席尔瓦模式和淋巴血管入侵 (LVI).
- 这种对EA的二进制系统的观察者间可重复性尚未先前确定.
研究的目的:
- 评估基于HPV相关EA的二进制模式分类系统的观察者间协议.
- 将二进制系统的可复制性与传统的三层席尔瓦分类系统进行比较.
- 评估二进制系统对EA风险分层的影响.
主要方法:
- 五位妇科病理学家在线培训模块后独立审查了59个HPV相关EA的幻灯片.
- 病理学家最初使用三层系统来分配模式.
- 随后,他们分配了一个二进制风险 (低/高),并记录了LVI,使用Fleiss' kappa.评估观察者之间的协议.
主要成果:
- 与三层系统 (kappa=0.564) 相比,二进制系统表现出更好的观察者间协议 (kappa=0.634).
- 在较高比例的案件中,至少4/5的审稿人与二进制系统达成一致 (86%与73%对比).
- 大多数审查者没有显示观察者内部差异,只有在少数病例中出现小差异.
结论:
- 基于二进制模式的分类系统与HPV相关EA的传统三层系统相比,表现出更高的观察者间一致性.
- 这种二进制系统具有更一致的风险评估和改善宫内腺癌的预后分层的潜力.
- 需要进一步验证,以确认其在管理EA方面的临床实用性.
相关概念视频
Classification of Epithelial Tissues: Overview
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Based on the number of cell layers,...
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Classification of Epithelial Tissues: Glandular Epithelium
The glandular epithelium is made of one or more epithelial cells modified to synthesize and secrete chemical substances. Glandular epithelia can be classified based on cell number. Unicellular glands have individual secretory cells scattered across the epithelial monolayer. In contrast, multicellular glands consist of a hollow tubular duct attached to the cluster of secretory cells located in the deep pockets.
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