Paradiso A, Ellis I O, Zito F A, Marubini E, Pizzamiglio S, Verderio P
Italian Network for Quality Assessment of Tumour Biomarkers, National Cancer Institute, Bari, Italy.
J Clin Pathol. 2009 Mar;62(3):279-81. doi: 10.1136/jcp.2008.061036.
Although the introduction of the Nottingham/Tenovus classification has improved the criteria to assess the histological grading in breast cancer, several quality control studies have shown that good results in terms of reproducibility are hard to obtain. This paper reports the results obtained during an implemented quality control programme for histological grading aimed at evaluating the short- and long-term effects of a training session on pathologists' performance. The interobserver reproducibility for grading score along with its components was assessed. The reproducibility between each pathologist and the reference values was also evaluated, as well as the contribution of each grading category to the observed reproducibility. Results show the weakness of a single training course in improving the long-term performance of the participating pathologists, suggesting the need to continuously monitor the quality of the grading determination by planning quality control studies and training sessions sequentially repeated in short time intervals.
尽管诺丁汉/特诺弗斯分类法的引入改进了评估乳腺癌组织学分级的标准，但多项质量控制研究表明，在可重复性方面很难取得良好结果。本文报告了在一项实施的组织学分级质量控制计划中所取得的结果，该计划旨在评估培训课程对病理学家表现的短期和长期影响。评估了分级分数及其组成部分的观察者间可重复性。还评估了每位病理学家与参考值之间的可重复性，以及每个分级类别对观察到的可重复性的贡献。结果表明，单一培训课程在提高参与病理学家的长期表现方面存在不足，这表明需要通过规划在短时间间隔内依次重复的质量控制研究和培训课程来持续监测分级判定的质量。
