Lym Ryan L, Ostrom Quinn T, Kruchko Carol, Couce Marta, Brat Daniel J, Louis David N, Barnholtz-Sloan Jill S
Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH, USA,
J Neurooncol. 2015 May;123(1):43-51. doi: 10.1007/s11060-015-1775-4. Epub 2015 Apr 12.
Central nervous system (CNS) tumors are categorized and graded for clinical and research purposes according to the World Health Organization (WHO) scheme which segregates tumors by histological type and predicted biological behavior. However, reporting of WHO grade in pathological reports is inconsistent despite its collection in cancer registration. We studied the completeness, concordancy, and yearly trends in the collection of WHO grade for primary CNS tumors between 2004 and 2011. Data from the Surveillance, Epidemiology and End Results program were analyzed for the percentage of histologically diagnosed primary CNS tumor cases with concordantly documented WHO grades between 2004 and 2011. Yearly trends were calculated with annual percentage changes (APC) and 95% confidence intervals (95% CI). Completeness and concordancy of the collection of WHO grade varied significantly by histological type and year. The percentage of cases with documented WHO grade increased significantly from 2004 to 2011: 39.0% of cases in 2004 had documented WHO grade, while 77.5% of cases had documented grade in 2011 (APC, 10.3; 95% CI: 9.0, 11.5). Among cases with documented WHO grade, the percentage graded concordantly increased significantly from 89.1% in 2004 to 93.7% in 2007 (APC, 1.8; 95% CI: 1.0, 2.6) and these values varied over time by histological type. One common trend among all histologies was a significant increase in the percentage of cases with documented WHO grade. A sizeable proportion of reported CNS tumors collected by cancer registrars have undocumented WHO grade, while a much smaller proportion are graded discordantly. Data collection on grade has improved in completeness and concordancy over time. Efforts to further improve collection of this variable are essential for clinical care and the epidemiological surveillance of CNS tumors.
出于临床和研究目的，中枢神经系统（CNS）肿瘤根据世界卫生组织（WHO）的方案进行分类和分级，该方案按组织学类型和预测的生物学行为对肿瘤进行分类。然而，尽管癌症登记处收集了WHO分级信息，但病理报告中WHO分级的报告并不一致。我们研究了2004年至2011年间原发性CNS肿瘤WHO分级收集的完整性、一致性和年度趋势。分析了监测、流行病学和最终结果计划的数据，以了解2004年至2011年间组织学诊断的原发性CNS肿瘤病例中WHO分级记录一致的百分比。年度趋势通过年度百分比变化（APC）和95%置信区间（95%CI）计算。WHO分级收集的完整性和一致性因组织学类型和年份而异。2004年至2011年间，有记录的WHO分级病例百分比显著增加：2004年39.0%的病例有记录的WHO分级，而2011年77.5%的病例有记录的分级（APC，10.3；95%CI：9.0，11.5）。在有记录的WHO分级病例中，分级一致的百分比从2004年的89.1%显著增加到2007年的93.7%（APC，1.8；95%CI：1.0，2.6），并且这些值随时间因组织学类型而变化。所有组织学类型的一个共同趋势是有记录的WHO分级病例百分比显著增加。癌症登记员收集的报告CNS肿瘤中，相当大比例的病例没有记录WHO分级，而分级不一致的比例要小得多。随着时间的推移，分级数据收集在完整性和一致性方面有所改善。进一步改进该变量的收集工作对于CNS肿瘤的临床护理和流行病学监测至关重要。
