Stang Andreas, Pohlabeln Hermann, Müller Klaus M, Jahn Ingeborg, Giersiepen Klaus, Jöckel Karl-Heinz
Institute of Medical Epidemiology, Biometry and Informatics, Medical Faculty, Martin-Luther-University of Halle-Wittenberg, Magdeburger Str. 27, 06097 Halle, Germany.
Lung Cancer. 2006 Apr;52(1):29-36. doi: 10.1016/j.lungcan.2005.11.012. Epub 2006 Feb 14.
Only few studies have compared the agreement of histological lung carcinoma diagnosis of a population-based case series and an independent pathology review. We analyzed data of our population-based lung cancer case-control study to determine the agreement in the histopathological evaluation of lung cancer. Six-hundred and sixty-eight out of 1004 interviewed male and female lung cancer cases were histologically evaluated according to the 1981 WHO classification by regional pathologists and a central pathologist who was blinded to the evaluations of the regional pathologists. The observed agreement was 0.65 with kappa = 0.54 (95% CI: 0.49-0.58). It was highest for small-cell carcinoma (0.94; kappa = 0.82) and lower for squamous-cell carcinoma (0.81; kappa = 0.58) and adenocarcinoma (0.81; kappa = 0.55). Agreement was slightly higher among women than men. The observed agreement among non-smoking cases was 58% as compared to 67% heavy smoking cases. The moderate agreement for squamous-cell and adenocarcinoma complicates epidemiological studies that address these histological subtypes.
仅有少数研究比较了基于人群的病例系列中组织学肺癌诊断与独立病理学复查之间的一致性。我们分析了基于人群的肺癌病例对照研究的数据，以确定肺癌组织病理学评估中的一致性。在1004名接受访谈的男性和女性肺癌病例中，有668例由地区病理学家和一名对地区病理学家的评估不知情的中心病理学家根据1981年世界卫生组织分类进行了组织学评估。观察到的一致性为0.65，kappa值为0.54（95%置信区间：0.49 - 0.58）。小细胞癌的一致性最高（0.94；kappa = 0.82），鳞状细胞癌（0.81；kappa = 0.58）和腺癌（0.81；kappa = 0.55）的一致性较低。女性中的一致性略高于男性。非吸烟病例中的观察到的一致性为58%，而重度吸烟病例为67%。鳞状细胞癌和腺癌的中度一致性使针对这些组织学亚型的流行病学研究变得复杂。
