Scott R T, Snyder R R, Strickland D M, Tyburski C C, Bagnall J A, Reed K R, Adair C A, Hensley S B
Department of Obstetrics and Gynecology, United States Air Force Medical Center, Lackland Air Force Base, Texas.
Fertil Steril. 1988 Dec;50(6):888-92. doi: 10.1016/s0015-0282(16)60367-9.
Endometrial biopsy specimens (n = 62) were evaluated by five pathologists to assess the effect of interobserver variation on histologic dating of the endometrium. The potential effect of this variation on the diagnosis of luteal phase defects (LPDs) and resulting clinical management was also determined. Mean (+/- standard error) interobserver variation was 0.96 +/- 0.08 days, comparable to results reported by other investigators. The magnitude of the variation was not affected by whether the biopsy specimen was obtained in the mid or late luteal phase, the degree of lag between the dating and subsequent menses, or the presence of an LPD. Redating of a specimen by another pathologist would have resulted in a change in the determination of "in" or "out" of phase in 22% of cases. The subsequent probability of changing patient management altered ranged from 22% to 39% depending on the clinical setting.
五名病理学家对62份子宫内膜活检标本进行了评估,以评估观察者间差异对子宫内膜组织学分期的影响。还确定了这种差异对黄体期缺陷(LPD)诊断及后续临床管理的潜在影响。观察者间差异的平均值(±标准误差)为0.96±0.08天,与其他研究者报告的结果相当。差异的大小不受活检标本是在黄体中期还是晚期获取、分期与随后月经之间的滞后程度或LPD是否存在的影响。由另一名病理学家对标本重新分期会导致22%的病例在分期的“相符”或“不符”判定上发生改变。根据临床情况,后续改变患者管理的概率在22%至39%之间。