对美国国立衰老研究所-阿尔茨海默病协会（NIA-AA）阿尔茨海默病神经病理学评估指南的多中心评估
Multisite assessment of NIA-AA guidelines for the neuropathologic evaluation of Alzheimer's disease.
作者信息
Montine Thomas J, Monsell Sarah E, Beach Thomas G, Bigio Eileen H, Bu Yunqi, Cairns Nigel J, Frosch Matthew, Henriksen Jonathan, Kofler Julia, Kukull Walter A, Lee Edward B, Nelson Peter T, Schantz Aimee M, Schneider Julie A, Sonnen Joshua A, Trojanowski John Q, Vinters Harry V, Zhou Xiao-Hua, Hyman Bradley T
机构信息
Department of Pathology, University of Washington, Seattle, WA, USA.
National Alzheimer Coordinating Center, University of Washington, Seattle, WA, USA.
出版信息
Alzheimers Dement. 2016 Feb;12(2):164-169. doi: 10.1016/j.jalz.2015.07.492. Epub 2015 Aug 29.
INTRODUCTION
Neuropathologic assessment is the current "gold standard" for evaluating the Alzheimer's disease (AD), but there is no consensus on the methods used.
METHODS
Fifteen unstained slides (8 brain regions) from each of the 14 cases were prepared and distributed to 10 different National Institute on Aging AD Centers for application of usual staining and evaluation following recently revised guidelines for AD neuropathologic change.
RESULTS
Current practice used in the AD Centers Program achieved robustly excellent agreement for the severity score for AD neuropathologic change (average weighted κ = .88, 95% confidence interval: 0.77-0.95) and good-to-excellent agreement for the three supporting scores. Some improvement was observed with consensus evaluation but not with central staining of slides. Evaluation of glass slides and digitally prepared whole-slide images was comparable.
DISCUSSION
AD neuropathologic evaluation as performed across AD Centers yields data that have high agreement with potential modifications for modest improvements.
引言
神经病理学评估是目前评估阿尔茨海默病（AD）的“金标准”，但所使用的方法尚无共识。
方法
从14例病例中的每例制备15张未染色切片（8个脑区），并分发给10个不同的美国国立衰老研究所AD中心，按照最近修订的AD神经病理学改变指南进行常规染色和评估。
结果
AD中心项目中目前使用的方法在AD神经病理学改变严重程度评分上达成了高度一致（平均加权κ = 0.88，95%置信区间：0.77 - 0.95），在三个支持性评分上达成了良好至高度一致。通过共识评估观察到了一些改进，但玻片的集中染色未带来改进。对玻片和数字制备的全玻片图像的评估具有可比性。
讨论
AD中心进行的AD神经病理学评估产生的数据具有高度一致性，可能进行适度改进。
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