皮肤恶性黑色素瘤组织学特征的观察者间可重复性

Interobserver reproducibility of histological features in cutaneous malignant melanoma.

作者信息

Urso C, Rongioletti F, Innocenzi D, Saieva C, Batolo D, Chimenti S, Filotico R, Gianotti R, Lentini M, Tomasini C, Rebora A, Pippione M

机构信息

Dermatopathology Section, S. M. Annunziata Hospital, Health Unit 10 of Florence, I-50011 Antella, Florence, Italy.

出版信息

J Clin Pathol. 2005 Nov;58(11):1194-8. doi: 10.1136/jcp.2005.026765.

DOI:10.1136/jcp.2005.026765

PMID:16254111

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1770759/

Abstract

AIMS

To assess the interobserver reproducibility of certain histological features proposed for the diagnosis of melanoma.

METHODS

In a series of melanomas, 13 histological parameters were analysed: dimension > 6 mm, asymmetry, poor circumscription, irregular confluent nests, single melanocytes predominating, absence of maturation, suprabasal melanocytes, asymmetrical melanin, melanin in deep cells, cytological atypia, mitoses, dermal lymphocytic infiltrate, and necrosis.

RESULTS

The agreement (reproducibility) between the nine observers was excellent (kappa > 0.75) for 10 of the 13 examined features (dimension > 6 mm, poor circumscription, irregular confluent nests, single melanocytes predominating, absence of maturation, suprabasal melanocytes, asymmetrical melanin, melanin in deep cells, mitoses, and necrosis). The agreement for asymmetry was very close to excellence (kappa = 0.74), and that for cytological atypia (kappa = 0.65) and dermal lymphocytic infiltrate (kappa = 0.47) was slightly lower, but in the fair to good agreement range. The kappa values obtained by comparison with the majority diagnosis were generally high (> or = 0.85); the mean value of kappa was lower (0.70) for only one parameter (dermal lymphocytic infiltrate).

CONCLUSIONS

The parameters investigated showed an overall good reproducibility.

摘要

目的

评估为黑色素瘤诊断所提出的某些组织学特征在不同观察者之间的可重复性。

方法

在一系列黑色素瘤中，分析了13个组织学参数：尺寸>6mm、不对称性、边界不清、不规则融合巢、单个黑素细胞占主导、无成熟现象、基底层上黑素细胞、不对称黑色素、深层细胞中的黑色素、细胞学异型性、核分裂象、真皮淋巴细胞浸润和坏死。

结果

对于13个检查特征中的10个（尺寸>6mm、边界不清、不规则融合巢、单个黑素细胞占主导、无成熟现象、基底层上黑素细胞、不对称黑色素、深层细胞中的黑色素、核分裂象和坏死），9名观察者之间的一致性（可重复性）极佳（kappa>0.75）。不对称性的一致性非常接近极佳水平（kappa=0.74），细胞学异型性（kappa=0.65）和真皮淋巴细胞浸润（kappa=0.47）的一致性略低，但处于中等至良好的一致范围内。与多数诊断结果相比获得的kappa值通常较高（≥0.85）；仅一个参数（真皮淋巴细胞浸润）的kappa平均值较低（0.70）。