Boiesen P, Bendahl P O, Anagnostaki L, Domanski H, Holm E, Idvall I, Johansson S, Ljungberg O, Ringberg A, Ostberg G, Fernö M
Pathologic Department, Hospital in Helsingborg, Sweden.
Acta Oncol. 2000;39(1):41-5. doi: 10.1080/028418600430950.
Histologic grade, including tubular formations, nuclear grade, and mitotic activity, is a well-documented prognostic factor in breast cancer. In comparison with other prognostic parameters, the evaluation of histologic grade is cheap and can be performed, in principle, in all cases of breast cancer. One possible disadvantage is that the evaluation may vary between different pathological departments. The aim of the present work was therefore to study the reproducibility of the histologic grading system by distributing haematoxylin-erythrosin-stained slides from 93 invasive breast cancers to the seven pathology departments within the southern healthcare region of Sweden. The evaluation was performed blindly and without any knowledge of other clinical parameters. In 31% of the cases the same histologic grade was obtained for all departments. The overall mean kappa was 0.54, indicating a moderate reproducibility. Of the three factors included in histologic grade, the agreement was best for tubular formations and poorest for nuclear grade and mitotic activity. The overall moderate reproducibility should be considered when the clinical usefulness of histologic grading is compared with other prognostic instruments.
组织学分级，包括管状结构、核分级和有丝分裂活性，是乳腺癌中一个有充分文献记载的预后因素。与其他预后参数相比，组织学分级评估成本低廉，原则上在所有乳腺癌病例中均可进行。一个可能的缺点是，不同病理科室之间的评估可能存在差异。因此，本研究的目的是通过将93例浸润性乳腺癌的苏木精-伊红染色切片分发给瑞典南部医疗保健区域内的七个病理科室，来研究组织学分级系统的可重复性。评估是在不知情的情况下进行的，且不了解任何其他临床参数。在31%的病例中，所有科室得出的组织学分级相同。总体平均kappa值为0.54，表明可重复性中等。在组织学分级所包含的三个因素中，管状结构的一致性最佳，核分级和有丝分裂活性的一致性最差。在将组织学分级的临床实用性与其他预后工具进行比较时，应考虑总体中等的可重复性。
