Smoller B R, Egbert B M
Department of Pathology, Stanford University Hospital, CA 94305.
J Am Acad Dermatol. 1992 Sep;27(3):399-402. doi: 10.1016/0190-9622(92)70206-u.
Poor interobserver reproducibility in diagnosing and grading dysplastic melanocytic nevi is often cited as evidence against the ability of pathologists to recognize such an entity.
We attempted to examine the diagnostic profiles of melanocytic lesions of two dermatopathologists in a stable population base.
All 2600 melanocytic neoplasms were diagnosed at Stanford University Medical Center during the past 4 years by one dermatopathologist from 1987 to 1989 and a different dermatopathologist in 1990 and 1991. The two independently evaluated these lesions unaware of the other's criteria.
The diagnostic profile of the two pathologists shows a striking degree of similarity: 76.7% versus 75.3% of all nevi were diagnosed as acquired melanocytic nevi, 8.8% versus 12.0% were diagnosed as mildly dysplastic, 7.0% versus 6.8% as moderately dysplastic, and 2.7% versus 1.6% as severely dysplastic.
Our findings suggest that the two pathologists are using reproducible criteria for diagnosing and grading dysplastic nevi.
在诊断和分级发育异常性黑素细胞痣时，不同观察者之间再现性差常被引为反对病理学家识别此类病变能力的证据。
我们试图在一个稳定的人群基础上研究两位皮肤病理学家对黑素细胞病变的诊断情况。
在过去4年里，斯坦福大学医学中心的所有2600例黑素细胞肿瘤，1987年至1989年由一位皮肤病理学家诊断，1990年和1991年由另一位不同的皮肤病理学家诊断。这两位医生在不知道对方标准的情况下独立评估这些病变。
两位病理学家的诊断情况显示出惊人的相似程度：所有痣中，分别有76.7%和75.3%被诊断为获得性黑素细胞痣，8.8%和12.0%被诊断为轻度发育异常，7.0%和6.8%为中度发育异常，2.7%和1.6%为重度发育异常。
我们的研究结果表明，两位病理学家在诊断和分级发育异常痣时使用了可重复的标准。
