Urologic Oncology Branch, National Cancer Institute, Bethesda, MD.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.
Urol Oncol. 2014 Jan;32(1):23.e9-13. doi: 10.1016/j.urolonc.2012.08.011. Epub 2013 Feb 28.
The Surveillance, Epidemiology, and End Results (SEER) program is an important epidemiologic research tool to study cancer. No information is available on its pathologic accuracy for renal cell carcinoma (RCC).
Central pathology review was analyzed as a part of the United States Kidney Cancer Study. Cases previously identified through the Detroit SEER registry were reviewed. The sensitivity and specificity, and positive and negative predictive values were calculated for each SEER-assigned subtype, with the central review assignments used as the reference.
Of the 498 cases included in this study, 490 (98.5%) were confirmed to be RCC. The overall agreement for histology was 78.2% (κ = 0.55); however, individual cases were frequently reclassified. The sensitivity and specificity for SEER-assigned clear cell RCC were 79.1% and 88.1%, respectively, when based solely on the ICD-O-3 morphology code 8310 (n = 310), and 99.2% and 80.5% when 8312 (RCC not otherwise specified; n = 41) was also assumed to be clear cell. Although RCC not otherwise specified is frequently grouped with clear cell, only 78.1% had this histology. Assignments of papillary and chromophobe RCC had comparable sensitivities (73.5% and 72.4%, respectively) and specificities (97.5% and 97.6%). Positive predictive values for clear cell (excluding/including 8312), papillary, and chromophobe RCC were 95.5%/93.5%, 85.9%, and 65.6%, respectively.
Our findings confirm that nearly all RCC cases are correctly classified in SEER. The positive predictive value was higher for clear cell RCC than for papillary or chromophobe RCC, suggesting that pathologic confirmation may be warranted for studies of non-clear cell tumors.
监测、流行病学和最终结果（SEER）计划是研究癌症的重要流行病学研究工具。目前尚无关于其在肾细胞癌（RCC）病理准确性的信息。
中央病理审查作为美国肾脏癌研究的一部分进行了分析。对先前通过底特律 SEER 登记处确定的病例进行了审查。计算了每种 SEER 分配亚型的敏感性、特异性、阳性和阴性预测值，以中央审查分配作为参考。
在本研究中包括的 498 例病例中，490 例（98.5%）被确认为 RCC。组织学的总体一致性为 78.2%（κ=0.55）；然而，个别病例经常被重新分类。仅基于 ICD-O-3 形态学代码 8310（n=310）分配的 SEER 分配透明细胞 RCC 的敏感性和特异性分别为 79.1%和 88.1%，当同时假定 8312（未特指的 RCC；n=41）也为透明细胞时，敏感性和特异性分别为 99.2%和 80.5%。虽然未特指的 RCC 通常与透明细胞 RCC 分组，但只有 78.1%具有这种组织学特征。乳头状和嫌色细胞 RCC 的分配具有相似的敏感性（分别为 73.5%和 72.4%）和特异性（分别为 97.5%和 97.6%）。透明细胞（不包括/包括 8312）、乳头状和嫌色细胞 RCC 的阳性预测值分别为 95.5%/93.5%、85.9%和 65.6%。
我们的发现证实，SEER 中几乎所有的 RCC 病例都得到了正确分类。透明细胞 RCC 的阳性预测值高于乳头状或嫌色细胞 RCC，这表明对于非透明细胞肿瘤的研究可能需要进行病理证实。
