Bori Rita, Salamon Ferenc, Móczár Csaba, Cserni Gábor
Bács-Kiskun Megyei Kórház Kecskemét Nyíri.
Orv Hetil. 2013 Aug 4;154(31):1219-25. doi: 10.1556/OH.2013.29659.
Gleason grading is the most common method of prostate cancer classification.
The aim of the authors was to assess the reproducibility of Gleason grading among pathologists using the same needle biopsy samples.
23 pathologists examined 37 prostate cancer biopsies stained with hematoxylin and eosin. Gleason scores were categorised into 4 groups (2-4, 5-6, 7 and 8-10). Kappa statistics were used to reflect interobserver agreement.
Considering all participating pathologists, grouping into one of the 4 categories resulted in an overall kappa value of 0.49. For the individual categories, the worst agreement (kappa = 0.15) was seen with well differentiated carcinomas, and the best (kappa = 0.65) with poorly differentiated ones.
These results suggest that Gleason grading in biopsy samples is moderately reproducible. The kappa values vary according to the differentiation of the cancer, and there is not much difference between the results of the present study and those published in the literature. To increase reproducibility, trainings should be organised, and this could improve the quality of grading.
格里森分级是前列腺癌分类最常用的方法。
作者的目的是评估使用相同针吸活检样本的病理学家之间格里森分级的可重复性。
23名病理学家检查了37例苏木精和伊红染色的前列腺癌活检样本。格里森评分分为4组(2 - 4分、5 - 6分、7分和8 - 10分)。kappa统计量用于反映观察者间的一致性。
考虑所有参与的病理学家,分为4类中的一类时,总体kappa值为0.49。对于各个类别,高分化癌的一致性最差(kappa = 0.15),低分化癌的一致性最好(kappa = 0.65)。
这些结果表明活检样本中的格里森分级具有中等可重复性。kappa值根据癌症的分化程度而变化,本研究结果与文献报道的结果差异不大。为提高可重复性,应组织培训,这可能会提高分级质量。