Duray P H, DerSimonian R, Barnhill R, Stenn K, Ernstoff M S, Fine J, Kirkwood J M
Department of Pathology, Yale University School of Medicine, New Haven, Connecticut.
J Am Acad Dermatol. 1992 Nov;27(5 Pt 1):741-9. doi: 10.1016/0190-9622(92)70248-e.
The diagnostic criteria for the histopathologic recognition of the dysplastic nevus are defined, but difficult to apply in practice. However, the use of skin biopsy is on the increase to search for this nevus because of a possible role in melanomagenesis.
The aim was to determine the degree of observer reproducibility in the detection of histologic nevomelanocytic dysplasia as measured across multiple observers and to test whether each observer was precise over a wide sample population. A second aim was to gain some measure of the threshold a person has for such lesions.
Histologic specimens from 50 coded nevomelanocytic tumors, which included a group of dysplastic nevi, were independently read by five observers in a blinded fashion. At study completion, the same 50 cases were read again by a melanoma reference pathologist and results analyzed by Cohen's kappa to assess agreement and interobserver variation.
Corrected rates of agreement for dysplastic nevi ranged from 0.32 to 0.71.
Continued study and experience are required for precision and reproducibility in the histologic recognition of dysplastic nevi.
发育异常痣的组织病理学诊断标准已明确，但在实际应用中存在困难。然而，由于皮肤活检在黑色素瘤发生过程中可能发挥作用，其应用正在增加，以寻找这种痣。
目的是确定在多个观察者中检测组织学痣黑素细胞发育异常的观察者再现程度，并测试每个观察者在广泛样本群体中是否精确。第二个目的是对人们识别此类病变的阈值进行一定程度的衡量。
50份编码的痣黑素细胞肿瘤组织学标本，其中包括一组发育异常痣，由5名观察者以盲法独立阅读。研究结束时，同一位黑色素瘤参考病理学家再次阅读这50个病例，并通过科恩kappa检验分析结果，以评估一致性和观察者间差异。
发育异常痣的校正一致率在0.32至0.71之间。
在发育异常痣的组织学识别中，需要持续的研究和经验来提高准确性和再现性。
