School of Medicine, Hacettepe University, Ankara, Turkey.
Department of Pathology, School of Medicine, Hacettepe University, Ankara, Turkey.
J Eur Acad Dermatol Venereol. 2021 Nov;35(11):2219-2224. doi: 10.1111/jdv.17574. Epub 2021 Aug 11.
Mohs micrographic surgery is the gold standard treatment for high-risk non-melanoma skin cancers. The success of Mohs relies on accurate histopathologic evaluation. Due to law restrictions in some European countries, Mohs surgeons are not permitted to report on histopathology; therefore, a pathologist evaluates the frozen sections.
To retrospectively assess the concordance between the certified Mohs surgeon and the pathologist in evaluating the Mohs slides that were intraoperatively evaluated by the pathologist.
Frozen section slides of a total of 237 Mohs cases between 2013 and 2020 were examined by the blinded Mohs surgeon, and the tumours were marked on copy maps. The copy maps and the original maps were compared, and the non-concordant cases were re-evaluated together by the Mohs surgeon and the dermatopathologist. The concordance rate was calculated, and the inter-rater agreement was statistically analysed using Cohen's Kappa coefficient.
We report a high concordance rate (97.9%) and inter-rater agreement (0.96) between Mohs surgeon and dermatopathologist in evaluating Mohs slides.
As a newly settled centre, our results are in alignment with experienced centres where the Mohs surgeon evaluates the slides herself and performs the surgery.
Mohs 显微外科手术是治疗高危非黑素瘤皮肤癌的金标准治疗方法。Mohs 的成功依赖于准确的组织病理学评估。由于一些欧洲国家的法律限制，Mohs 外科医生不被允许报告组织病理学；因此，病理学家评估冷冻切片。
回顾性评估由病理学家术中评估的 Mohs 切片中，认证的 Mohs 外科医生和病理学家之间的一致性。
对 2013 年至 2020 年间共 237 例 Mohs 病例的冷冻切片进行了盲法 Mohs 外科医生检查，并在复制图上标记肿瘤。比较复制图和原始图，并由 Mohs 外科医生和皮肤科病理学家共同重新评估不一致的病例。计算一致性率，并使用 Cohen's Kappa 系数对评分者间一致性进行统计学分析。
我们报告了 Mohs 外科医生和皮肤科病理学家在评估 Mohs 切片时的高一致性率（97.9%）和评分者间一致性（0.96）。
作为一个新成立的中心，我们的结果与经验丰富的中心一致，在这些中心，Mohs 外科医生自己评估切片并进行手术。
