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Updated: Feb 3, 2026

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尽管简化了诊断标准,但在解释结直肠状息肉时,观察者内部和观察者间的变异性仍然存在

Adam L Booth¹, Emina E Torlakovic², Runjan Chetty³

¹Washington University School of Medicine, St. Louis, Missouri, USA.

|February 1, 2026

概括

区分结直肠形形病变 (SSL) 和多重塑性息肉 (HP) 仍然具有挑战性. 结合多体大小和位置以及密码扭曲,可以提高诊断准确性和可重复性.

科学领域:

胃肠病学胃肠病学
病理学病理学病理学
结肠直肠癌查结肠直肠癌查

背景情况:

在状状病变 (SSL) 和高塑性息肉 (HP) 之间进行组织学区分是具有挑战性的,观察者之间存在显著的变异性.
2019年世界卫生组织 (WHO) 关于SSL诊断的标准,强调建筑上扭曲的形密码,旨在简化诊断,但挑战仍然存在.

研究的目的:

评估在胃肠道病理学家中诊断SSL与HP的观察者变异性.
确定SSL的首选诊断标准,并评估额外的临床信息对诊断协议的影响.

主要方法:

使用整片图像对60个状结直肠多的回顾性分析.
由13名病理学家进行多轮审查,提供了不同的信息 (仅包括组织学,组织学与大小/位置).
观察者之间的和观察者内部的协议使用Fleiss和Cohen的kappa值进行评估.

主要成果:

总体而言,观察者之间的一致性是适度的,当病理学家能够访问多体大小和部位信息时,情况会有所改善.
密码扭曲是SSL诊断中普遍认为有用的唯一特征,符合世卫组织的标准.
诊断一致性最差的是横横结肠聚体和测量≥1.0厘米的聚体.

结论:

非组织学因素,如息肉大小和位置,可能对SSL与HP的准确和可重现的差异化至关重要.
进一步验证这些非组织学标准是有必要的,以提高诊断的一致性.

关键词:

结直肠癌结直肠癌.过度增生性聚类 (hyperplastic polyp) 是一种过度增生性聚类.观察者可变性的变化.状状病变的病变可能是状的.状有状的多/腺瘤

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