用核特征和血管和囊入侵来评估甲状腺新生瘤的诊断挑战:多中心观察者间协议研究
Agnes Stephanie Harahap1,2, Mutiah Mutmainnah3, Maria Francisca Ham1,2
1Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Journal of pathology and translational medicine
|September 11, 2024
概括
印度尼西亚病理学家对甲状腺瘤诊断的共识很差,这凸显了需要改善培训和合作的需要. 培训后的评估显示,诊断一致性显著改善.
科学领域:
- 病理学 病理学 病理学
- 在瘤学瘤学.
- 医学教育 医学教育
背景情况:
- 甲状腺瘤的准确诊断依赖于精确的组织学特征识别.
- 病理学家之间诊断解释的变化存在于印度尼西亚的医疗保健中心.
研究的目的:
- 评估印尼病理学家在诊断甲状腺瘤方面的观察者间一致性.
- 评估针对性培训对改善诊断协议的影响.
主要方法:
- 15名病理学家独立审查了14张甲状腺瘤样本的数字幻灯片.
- 使用Fleiss kappa对训练前后的核特征,囊和血管入侵进行了评估.
- 配对的t测试分析了培训干预措施的意义.
主要成果:
- 关于核特征的基准协议范围从差到相当 (kappa = -0.02到0.28).
- 血管入侵 (kappa = 0.35) 和囊入侵 (kappa = 0.27) 的一致性是公平的.
- 关于估计的分子类型的共识很大 (kappa = 0.74).
- 在培训后,关于八点核特征系统的协议显著改善 (p = 0.001).
结论:
- 印度尼西亚病理学家在诊断甲状腺瘤方面的总体一致性不足.
- 加强合作和持续教育对于标准化诊断标准和改善病理学共识至关重要.
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