Pathologica. 2005 Feb;97(1):1-6.
Although the diagnostic criteria for histological grading in breast cancer have been improved by the introduction of the Nottingham/Tenovus classification, good results in terms of reproducibility are hard to obtain. The objective of this study was to validate a methodological protocol for external quality control. We assessed the intra- and interlaboratory reproducibility for grading score and its components. Our findings revealed a less than optimal level of agreement for both intra-observer and interobserver reproducibility. Each grading class contributed in a different way to the reproducibility and class G2 provided the poorest contribution to the observed agreement. Nuclear pleomorphism appeared to be the least reproducible, followed by mitotic count and tubule formation. In conclusion, our results suggest the need for quality control programs that should be conceived as a dynamic feedback process to better understand the reasons for some unsatisfactory performances and to implement the necessary corrective actions.
尽管通过引入诺丁汉/特诺夫斯分类法改进了乳腺癌组织学分级的诊断标准，但在可重复性方面很难取得良好的结果。本研究的目的是验证一种用于外部质量控制的方法方案。我们评估了分级分数及其组成部分在实验室内和实验室间的可重复性。我们的研究结果显示，观察者内和观察者间的可重复性一致性水平均未达到最佳。每个分级类别对可重复性的贡献方式不同，G2级对观察到的一致性贡献最差。核多形性似乎是最不可重复的，其次是有丝分裂计数和小管形成。总之，我们的结果表明需要将质量控制程序视为一个动态反馈过程，以更好地理解某些不理想表现的原因并采取必要的纠正措施。
