Pathology, CHU Brest, Brest, Bretagne, France
J Clin Pathol. 2022 Feb;75(2):137-139. doi: 10.1136/jclinpath-2020-207378. Epub 2021 Feb 10.
To diagnose (HP) infection and its related mucosal injuries requires the histopathological analysis of gastric biopsies. The move from glass slides interpretation towards digital pathology implies technical choices to maintain the performances of histopathological diagnosis. The intra-rater agreement in assessing gastritis diagnostic criteria between glass slides, low resolution and high resolution digital slides in the subject of the present study. One hundred gastric biopsies were re-assessed by a single digestive pathologist on glass slides and digitalised slides at low resolution (ie, x20 magnification and single focus without z-stack) and high resolution (ie, x40 magnification with seven focus levels and z-stack) about the criteria of the updated Sydney system and the detection of HP. Inter-analyses agreement were very good (Kappa values>0.81) for every criteria but slightly inferior (ie, Kappa values<0.9) comparing glass slides interpretations with low resolution digital slides-based ones. Indeed, some HP infections were misdiagnosed using x20 magnification histochemical stained digitalised slides (p<0.05). At the opposite, anti-HP immunohistochemistry slides and/or x40 magnification digitalisation permitted to maintain almost perfect concordance in diagnosis (Kappa value>0.9). As mentioned in current guidelines, a high resolution x40 magnification digitalisation must be favoured in order to avoid some misdetection of microorganisms as HP.
要诊断（HP）感染及其相关黏膜损伤，需要对胃活检进行组织病理学分析。从玻璃载玻片解释转向数字病理学意味着需要进行技术选择，以保持组织病理学诊断的性能。在本研究中，评估玻璃载玻片、低分辨率和高分辨率数字载玻片之间的胃炎诊断标准的观察者内一致性。一位消化病理学家对 100 份胃活检进行了重新评估，评估对象为经过更新的悉尼系统标准和幽门螺杆菌（HP）检测的玻璃载玻片和低分辨率数字载玻片（即 20 倍放大率和单个焦点，无 z 堆叠）以及高分辨率数字载玻片（即 40 倍放大率，具有七个焦点水平和 z 堆叠）。除了与低分辨率数字载玻片相比，每个标准的分析一致性都非常好（Kappa 值>0.81）。事实上，一些 HP 感染在使用 20 倍放大率组织化学染色数字载玻片时被误诊（p<0.05）。相反，抗 HP 免疫组织化学载玻片和/或 40 倍放大率数字化几乎可以保持诊断的完美一致性（Kappa 值>0.9）。正如当前指南中提到的，为了避免某些微生物（如 HP）的漏检，必须采用高分辨率的 40 倍放大率数字化。
