Lidbury J A, Rodrigues Hoffmann A, Ivanek R, Cullen J M, Porter B F, Oliveira F, Van Winkle T J, Grinwis G C, Sucholdolski J S, Steiner J M
Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX.
Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX.
J Vet Intern Med. 2017 May;31(3):778-783. doi: 10.1111/jvim.14684. Epub 2017 Mar 14.
Grading schemes for the assessment of hepatic fibrosis and necroinflammatory activity in humans previously have been applied to dogs with chronic hepatitis. Interobserver agreement is a desirable characteristic for any histological scoring scheme.
HYPOTHESIS/OBJECTIVES: To assess interobserver agreement associated with pathologists using a previously published histological scoring scheme to assess hepatic fibrosis and necroinflammatory activity in dogs and to compare fibrosis scores assigned to serial sections stained with hematoxylin & eosin (H&E) and picrosirius red.
Histological sections of liver from 50 dogs with variable degrees of hepatic fibrosis and necroinflammatory activity were selected from institutional tissue archives.
Six board-certified veterinary anatomic pathologists assigned fibrosis and necroinflammatory activity scores to the histological sections. The multiuser kappa statistic was calculated to assess interobserver agreement. Fibrosis stage assigned to serial sections stained with picrosirius red and H&E was compared using the Wilcoxon signed-rank test.
Multiuser kappa statistics for assessment of fibrosis and necroinflammatory activity from H&E-stained sections were 0.35 and 0.16, respectively. There was no difference in median fibrosis scores assigned to serial section stained with H&E and picrosirius red (P = .248).
There was fair interobserver agreement when pathologists assessed fibrosis and poor agreement when they assessed necroinflammatory activity. This suboptimal agreement must be taken into account by clinicians making decisions based on histology reports of the liver and in the design of studies evaluating these findings. To decrease this variability, ideally >1 pathologist should evaluate each section.
人类肝纤维化和坏死性炎症活动评估的分级方案先前已应用于患有慢性肝炎的犬类。观察者间的一致性是任何组织学评分方案的理想特征。
假设/目标：使用先前发表的组织学评分方案评估犬类肝纤维化和坏死性炎症活动，以评估病理学家之间的观察者间一致性，并比较苏木精和伊红（H&E）染色及苦味酸天狼星红染色的连续切片的纤维化评分。
从机构组织档案中选取50只具有不同程度肝纤维化和坏死性炎症活动的犬类肝脏组织切片。
六位获得委员会认证的兽医解剖病理学家对组织学切片进行纤维化和坏死性炎症活动评分。计算多用户kappa统计量以评估观察者间的一致性。使用Wilcoxon符号秩检验比较苦味酸天狼星红和H&E染色的连续切片的纤维化分期。
H&E染色切片评估纤维化和坏死性炎症活动的多用户kappa统计量分别为0.35和0.16。H&E染色和苦味酸天狼星红染色的连续切片的中位纤维化评分无差异（P = 0.248）。
病理学家评估纤维化时观察者间一致性尚可，评估坏死性炎症活动时一致性较差。临床医生在根据肝脏组织学报告做决策以及设计评估这些结果的研究时，必须考虑到这种不太理想的一致性。为减少这种变异性，理想情况下应由>1位病理学家评估每个切片。
