病理学家在结直肠多的组织病理学诊断和分类方面达成了观察者间的协议
Elham Jafari1, Mahdiye Lashkarizadeh2, Nazanin Zeinali Nezhad3
1Pathology and Stem Cell Research Center, Department of Pathology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Diagnostic pathology
|February 10, 2026
概括
病理学家对结直肠聚体诊断的共识总体上很好,但对于某些类型 (如超塑性和炎症性聚体) 有显著差异. 需要提高标准化和培训,以准确地分类发育不良和评估状损伤.
科学领域:
- 胃肠病学 胃肠病学
- 病理学 病理学 病理学
- 在瘤学瘤学.
背景情况:
- 准确的结直肠多瘤组织病理学诊断对于患者管理和癌症预防至关重要.
- 聚合物分类的观察者间变异性可能会影响治疗决策和患者的治疗结果.
研究的目的:
- 评估病理学家在诊断和分类结直肠多瘤方面的一致性.
- 为了确定特定的多类型和分级类别,具有显著的观察者之间的分歧.
主要方法:
- 一项涉及253个结直肠多样本的横截面研究,由三位经验丰富的病理学家进行评估.
- 息肉被分为六种类型,而形被分类.
- 观察者间的一致性用权重的科恩卡帕系数来量化.
主要成果:
- 对组织病理学诊断的总体一致性很好 (κ=0.66).
- 在现场癌瘤 (κ=0.87) 和腺瘤多瘤 (κ=0.78) 中观察到高度一致.
- 对于炎症性息肉 (κ=0.16) 和单独的直肠 (κ=0.12),一致性很差,而对于生殖不良等级 (κ=0.32) 则是公平的.
结论:
- 虽然对于腺瘤多和癌症有很强的共识,但对于其他多类型和失塑性分级存在显著的变化.
- 建议采用标准化诊断标准和有针对性的培训,以提高结直肠多评估的一致性.
- 应特别注意改善对状病变和发育不良等级的协议.
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