病理学家在乳腺癌半定量激素受体评分中的观察者间一致性。

Interobserver agreement among pathologists for semiquantitative hormone receptor scoring in breast carcinoma.

机构信息

Department of Pathology, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA.

出版信息

Am J Clin Pathol. 2012 Dec;138(6):796-802. doi: 10.1309/AJCP6DKRND5CKVDD.

Abstract

The American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines recommend reporting of hormone receptor test results in a semiquantitative manner. This study used 74 resected estrogen receptor (ER)-positive invasive breast cancers to determine reproducibility of semiquantitative scoring of hormone receptors using the H-score method. Four pathologists independently scored each slide. Agreement among observers was analyzed via Fleiss κ statistics on ER and progesterone receptor (PR) categorical scores. Intraclass correlation coefficient (ICC) was used to estimate the interobserver agreement for ER and PR H-scores on a continuous scale (0-300). There was 100% agreement for categorical ER results (κ = 1) and 97% agreement (κ = 0.823, P < .001) for categorical PR results. For quantitative H-scores, ICC agreement was 0.85 (95% confidence interval [CI] = 0.79-0.90) for ER and 0.87 (95% CI = 0.82-0.92) for PR. Because the H-score provides a continuous measure of tumor hormone receptor content, we suggest universal adoption of this method.

摘要

美国临床肿瘤学会/美国病理学家协会(ASCO/CAP)指南建议以半定量方式报告激素受体检测结果。本研究使用 74 例切除的雌激素受体(ER)阳性浸润性乳腺癌,以确定使用 H 评分法对半定量评分激素受体的重现性。四位病理学家独立对每张切片进行评分。采用 Fleiss κ 统计分析对 ER 和孕激素受体(PR)分类评分的观察者间一致性。使用组内相关系数(ICC)来估计 ER 和 PR H 评分在连续量表(0-300)上的观察者间一致性。分类 ER 结果具有 100%的一致性(κ=1),分类 PR 结果具有 97%的一致性(κ=0.823,P<.001)。对于定量 H 评分,ER 的 ICC 一致性为 0.85(95%置信区间[CI] = 0.79-0.90),PR 的 ICC 一致性为 0.87(95% CI = 0.82-0.92)。由于 H 评分提供了肿瘤激素受体含量的连续测量,因此我们建议普遍采用这种方法。

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