Koperek O, Scheuba C, Cherenko M, Neuhold N, De Micco C, Schmid K W, Niederle B, Kaserer K
Department of Clinical Pathology, Medical University of Vienna, Vienna, Austria.
Histopathology. 2008 Apr;52(5):623-30. doi: 10.1111/j.1365-2559.2008.03002.x.
To evaluate the reliability of desmoplasia as a reproducible morphological parameter indicating the metastatic potential of medullary thyroid carcinoma (MTC).
One hundred and twenty cases of MTC of the Medical University of Vienna, Austria and 76 cases from the School of Medicine of Marseille, France were analysed for the presence of desmoplastic stroma reaction by four endocrine pathologists. Intra- and interobserver concordance was assessed. The Austrian cases were also analysed for various morphological parameters. Intra- and interobserver concordance were highly significant with a kappa value of 0.883 for intra-observer reliability and 0.837, 0.79 and 0.758, respectively, when pathologists N.N., C.D.M. and K.W.S. reviewed the Austrian cases. The cases from France were reviewed by C.D.M. and K.K. with a kappa value of 0.759. None of the cases that were categorized as desmoplasia negative by any of the investigators showed lymph node metastasis. No other distinct morphological characteristics could be assigned to the MTCs without desmoplasia.
Our data indicate desmoplasia to be a reliable and highly reproducible parameter with regard to lymph node metastatic potential.
评估促纤维组织增生作为一种可重复的形态学参数，用以指示甲状腺髓样癌（MTC）转移潜能的可靠性。
奥地利维也纳医科大学的120例MTC病例以及法国马赛医学院的76例病例，由四位内分泌病理学家分析促纤维组织增生性间质反应的存在情况。评估了观察者内和观察者间的一致性。对奥地利的病例还分析了各种形态学参数。当病理学家N.N.、C.D.M.和K.W.S.复查奥地利的病例时，观察者内可靠性的kappa值为0.883，观察者间一致性分别为0.837、0.79和0.758，均具有高度显著性。法国的病例由C.D.M.和K.K.复查，kappa值为0.759。任何一位研究者判定为促纤维组织增生阴性的病例均未出现淋巴结转移。对于无促纤维组织增生的MTC，未发现其他明显的形态学特征。
我们的数据表明，促纤维组织增生在淋巴结转移潜能方面是一个可靠且高度可重复的参数。
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