定量测定滑膜炎评分及其各成分的诊断准确性。

Quantitative determination of the diagnostic accuracy of the synovitis score and its components.

机构信息

Medical Faculty 'Carl Gustav Carus', Technical University of Dresden, Germany.

出版信息

Histopathology. 2010 Sep;57(3):436-43. doi: 10.1111/j.1365-2559.2010.03641.x.

DOI:10.1111/j.1365-2559.2010.03641.x

PMID:20840673

Abstract

AIMS

To assess the diagnostic accuracy of a three-component synovitis score and to determine the relative contribution of each of its components to its overall discriminatory power.

METHODS AND RESULTS

The synovitis score was determined in 666 synovial specimens: normal synovium, n = 33; post-traumatic arthropathy (PtA), n = 29; osteoarthritis (OA), n = 221; psoriatic arthritis (PsA), n = 42; and rheumatoid arthritis (RA), n = 341. The discriminatory abilities of the score and its components were quantified with binary and multicategory receiver operating characteristic (ROC) analysis. The score differentiated all arthropathies accurately from normal tissue (area under the ROC curve, AUC: 0.87-0.98) and RA from OA or PtA (AUC: 0.85 for both), but could not distinguish well within pairs of inflammatory or degenerative arthropathies. AUCs of the intimal hyperplasia and stromal cellularity components correlated with the AUCs of the complete score markedly more strongly (r = 0.94 and 0.91, respectively) than the inflammatory infiltration component (r = 0.60). Multicategory ROC analysis ranked the score several-fold higher than any of its components, and the components in the order stromal cellularity>intimal hyperplasia>infiltration.

CONCLUSION

Combining three distinct histological parameters into a three-component score produces greatly increased overall diagnostic power. The discriminatory ability of the score stems more from measuring proliferative than infiltrative aspects of synovitis.

摘要

目的

评估三组分滑膜炎评分的诊断准确性，并确定其各组成部分对整体判别能力的相对贡献。

方法和结果

滑膜炎评分在 666 个滑膜标本中确定：正常滑膜，n = 33；创伤后关节炎（PtA），n = 29；骨关节炎（OA），n = 221；银屑病关节炎（PsA），n = 42；类风湿关节炎（RA），n = 341。使用二分类和多分类接受者操作特征（ROC）分析量化评分及其各组成部分的判别能力。该评分准确地区分了所有关节炎与正常组织（ROC 曲线下面积，AUC：0.87-0.98），以及 RA 与 OA 或 PtA（AUC：两者均为 0.85），但在炎症性或退行性关节炎之间无法很好地区分。内膜增生和基质细胞密度成分的 AUC 与完整评分的 AUC 相关性更强（r = 0.94 和 0.91，分别），而炎症浸润成分的相关性较弱（r = 0.60）。多分类 ROC 分析表明，评分的等级比其任何一个组成部分都要高几倍，且按基质细胞密度>内膜增生>浸润的顺序排列。