Karadeniz Technical University, Faculty of Medicine, Department of Pathology, Trabzon, Turkey.
Turk Neurosurg. 2020;30(5):643-650. doi: 10.5137/1019-5149.JTN.26252-19.2.
To evaluate the interobserver variability in determining the number of mitoses in 10 high-power field (HPF) and thus the tumor grade, and to investigate how to reduce grade discordance between the observers and the most useful method to identify the patients who would receive an additional treatment.
Two hundred and seventy cases with meningioma were re-evaluated by three experienced pathologists and five senior residents. They determined the number of mitotic figures in 10 HPF in each slide. Re-evaluation of the cases, which were found of different grades from the reference observers was requested by full scan method. Statistical analysis was performed by using SPSS V23.0.
A moderate agreement was found between the observers and the reference observer. After the evaluation of mitotic activity with the full scan method, the mean numbers of mitoses found by the observers in 10 HPF were increased. In the first evaluation, 4?6 cases were defined as Grade II by the observers. Whereas, 23?27 cases were defined as Grade II after the full scan method.
If there are less than 16 mitotic figures throughout the slide, it is more difficult to find the 10 HPF including 4 or more mitosis. Interobserver variability in mitotic figure counting can be reduced by full scan method, and examining the hematoxylin and eosin stained slides by the full scan method helps us to determine the true histologic grade of meningiomas in most cases, who would receive an additional treatment.
评估在 10 个高倍视野（HPF）中确定有丝分裂数从而确定肿瘤分级的观察者间变异性，并探讨如何减少观察者之间的分级差异，以及确定需要额外治疗的患者的最有用方法。
三位经验丰富的病理学家和五位高级住院医师对 270 例脑膜瘤病例进行了重新评估。他们在每个切片中确定了 10 HPF 中有丝分裂数。通过全扫描方法，要求重新评估与参考观察者分级不同的病例。使用 SPSS V23.0 进行统计分析。
观察者与参考观察者之间存在中度一致性。通过全扫描方法评估有丝分裂活性后，观察者在 10 HPF 中发现的有丝分裂数平均值增加。在第一次评估中，观察者将 4?6 例定义为 II 级。然而，在全扫描方法后，23?27 例被定义为 II 级。
如果整个切片中少于 16 个有丝分裂，在 10 HPF 中找到包含 4 个或更多有丝分裂的区域就更困难。通过全扫描方法可以减少有丝分裂计数的观察者间变异性，并且通过全扫描方法检查苏木精和伊红染色的切片有助于我们在大多数情况下确定脑膜瘤的真实组织学分级，这些患者需要额外的治疗。
