Department of Pathology, HELIOS Clinic Bad Saarow, Charité - University Medicine Teaching Hospital, Pieskower Street 33, 15526 Bad Saarow, Germany.
Pathol Res Pract. 2011 Feb 15;207(2):116-20. doi: 10.1016/j.prp.2010.11.007. Epub 2011 Jan 3.
Colorectal serrated polyps (CSPs) comprise hyperplastic polyps (HPs), traditional (TSAs) and sessile (SSAs) serrated adenomas, as well as inflammatory cloacogenic polyps (ICPs). These lesions have typical anatomical locations and share a histomorphological overlap. In this study, we assessed the so far neglected issue as to what extent the histological classification of these lesions performed by pathology trainees is biased by the pathologists' knowledge of the polyp location in dependency on the duration of their training. To reach this aim, 49 CSPs were classified by three pathology trainees blinded to clinical data. In a second round of examination, the same raters were provided with the polyp location. A third round was conducted after a consensus conference. Intra- and inter-rater analyses were performed using Kappa (K) statistics and Spearman correlations. Our data suggest that the histological classification of CSPs performed by pathology trainees might be influenced in a clinically significant fashion by knowledge of the anatomical polyp location depending on the duration of their pathology training.
结直肠锯齿状息肉（CSPs）包括增生性息肉（HPs）、传统锯齿状腺瘤（TSAs）和无蒂锯齿状腺瘤（SSAs）以及炎症性肛隐窝息肉（ICPs）。这些病变具有典型的解剖位置，并且在组织形态学上存在重叠。在这项研究中，我们评估了一个迄今为止被忽视的问题，即病理科住院医师对这些病变的组织学分类在多大程度上受到病理学家对息肉位置的了解的影响，而这种了解又取决于他们的培训时间。为了达到这个目的，我们对 49 个 CSP 进行了分类，由三位病理科住院医师对临床数据进行盲法评估。在第二轮检查中，同样的评估者提供了息肉的位置。在共识会议后进行了第三轮检查。使用 Kappa（K）统计和 Spearman 相关系数进行了组内和组间评估。我们的数据表明，病理科住院医师对 CSPs 的组织学分类可能会受到息肉解剖位置的影响，这种影响在临床上是显著的，并且取决于他们的病理培训时间。
