MacGrogan G, Arnould L, de Mascarel I, Vincent-Salomon A, Penault-Llorca F, Lacroix-Triki M, Bibeau F, Baranzelli M C, Fridman V, Antoine M, Bécette V, Brouste V, Jacquemier J, Mathoulin-Pélissier S
Department of Pathology, Institut Bergonié, Bordeaux, France.
Histopathology. 2008 May;52(6):689-97. doi: 10.1111/j.1365-2559.2008.03016.x. Epub 2008 Apr 5.
To assess the impact of cytokeratin (CK) 5/6 and E-cadherin immunohistochemistry on diagnostic agreement of non-invasive proliferative breast lesions.
Twenty pathologists classified 105 cases of non-invasive proliferative breast lesions into 10 diagnostic categories. One haematoxylin and eosin (H&E) slide of each case was analysed on a first round and one H&E slide with corresponding CK5/6 and E-cadherin immunohistochemistry was analysed on a second round. Interobserver reproducibility for category-specific and management-specific lesions was measured on each round. CK5/6 and E-cadherin had little impact on diagnostic agreement, which remained moderate between the first and second rounds (overall kappa coefficients of 0.47 and 0.53, respectively, P = NS). Levels of agreement slightly improved for lesions with specific CK5/6 and E-cadherin immunoprofiles (usual ductal hyperplasia, atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, non-high-grade ductal carcinoma in situ), but the differences observed were not statistically significant. However, diagnostic agreement improved when lesions were grouped according to their management category (overall kappa coefficients of 0.58 and 0.66 in the first and second rounds, respectively).
CK5/6 and E-cadherin immunohistochemistry has little impact on interobserver reproducibility for non-invasive breast lesions. Diagnostic agreement can, however, be improved by grouping lesions in management categories.
评估细胞角蛋白（CK）5/6和E-钙黏蛋白免疫组化对非侵袭性增生性乳腺病变诊断一致性的影响。
20名病理学家将105例非侵袭性增生性乳腺病变分为10个诊断类别。第一轮分析每例的一张苏木精-伊红（H&E）切片，第二轮分析一张带有相应CK5/6和E-钙黏蛋白免疫组化的H&E切片。在每一轮中测量特定类别和特定管理病变的观察者间再现性。CK5/6和E-钙黏蛋白对诊断一致性影响不大，两轮之间的一致性仍为中等（总体kappa系数分别为0.47和0.53，P =无显著性差异）。具有特定CK5/6和E-钙黏蛋白免疫表型的病变（普通导管增生、非典型导管增生、非典型小叶增生、小叶原位癌、非高级别导管原位癌）的一致性水平略有提高，但观察到的差异无统计学意义。然而，当根据病变的管理类别进行分组时，诊断一致性得到改善（第一轮和第二轮的总体kappa系数分别为0.58和0.66）。
CK5/6和E-钙黏蛋白免疫组化对非侵袭性乳腺病变的观察者间再现性影响不大。然而，通过将病变按管理类别分组可以提高诊断一致性。
