Brunnström Hans, Lindberg Eva, Englund Elisabet
Department of Pathology, Lund University and Regional Laboratories Region Skåne, Lund, Sweden.
Clin Neuropathol. 2012 Jul-Aug;31(4):216-23. doi: 10.5414/NP300471.
Lewy-related pathology is the characteristic feature of Parkinson's disease with and without dementia and dementia with Lewy bodies (DLB). There are two neuropathological staging systems for Lewy-related pathology commonly employed today: the staging system for Parkinson-related pathology by Braak et al., and the staging system by the Consortium on DLB. There are also several modified systems based on these two scales.
We applied a total of eight different staging systems for Lewy-related pathology to 36 consecutive demented patients with various dementia disorders.
The staging systems varied considerably in number of unclassifiable cases (range 0 – 16 out of 36 cases), while the diagnostic agreement between the systems that were able to classify all or the very majority of cases varied only slightly (weighted κ 0.86 – 0.92 and Spearman's σ 0.80 – 1.0).
The different staging systems for Lewy-related pathology that exist today vary in staging procedure and proportion of unclassifiable cases. The choice of system may affect the stage of Lewy-related pathology and ultimately final diagnosis.
路易体相关病理改变是帕金森病伴或不伴痴呆以及路易体痴呆（DLB）的特征性表现。目前常用的路易体相关病理改变的两种神经病理学分期系统为：Braak等人提出的帕金森相关病理分期系统，以及DLB联合会的分期系统。此外，还有基于这两种量表的几种改良系统。
我们将总共8种不同的路易体相关病理分期系统应用于36例患有各种痴呆症的连续痴呆患者。
分期系统在无法分类的病例数量上差异很大（36例中范围为0 - 16例），而能够对所有或绝大多数病例进行分类的系统之间的诊断一致性仅略有差异（加权κ为0.86 - 0.92，Spearman's σ为0.80 - 1.0）。
目前存在的不同路易体相关病理分期系统在分期程序和无法分类病例的比例上有所不同。系统的选择可能会影响路易体相关病理改变的分期，并最终影响最终诊断。
