Departments of Dermatology, and.
Pathology, University of Rochester Medical Center, Rochester, New York.
Dermatol Surg. 2021 Nov 1;47(11):1433-1437. doi: 10.1097/DSS.0000000000003213.
Current staging systems for cutaneous squamous cell carcinoma (cSCC) incorporate histologic grade. There are no universally agreed on criteria to define differentiation for cSCC.
To determine the interrater and intrarater reliability among dermatopathologists and Mohs surgeons in grading histological differentiation for cSCC.
One hundred thirty-one archived slides were selected. Three dermatopathologists and 3 Mohs surgeons graded the tumors in a blinded manner (Round 1). In an attempt to improve concordance, all 6 participants were then asked to regrade the tumors based on a devised quantitative grading scale (Round 2).
For Round 1, overall κ was 0.56 corresponding to a weak agreement. κ for well, moderate, and poorly differentiated tumors was 0.68, 0.39, and 0.59, respectively, corresponding to moderate, minimal, and weak concordance. For Round 2 of the study, overall κ was 0.60, with κ = 0.75, 0.46, and 0.61 for well, moderate, and poorly differentiated tumors, respectively. Overall intrarater reliability was 0.70 (κ = 0.70, 0.77, 0.68, 0.71, 0.56, and 0.75), corresponding to a moderate concordance.
Overall concordance for cSCC histologic grading is weak to moderate among the experimental group. Substantial differences in concordance exist among histological degrees of differentiation, with lowest agreement in moderately differentiated tumors.
目前用于皮肤鳞状细胞癌 (cSCC) 的分期系统包括组织学分级。对于 cSCC 的分化，目前尚无普遍认可的标准来定义。
确定皮肤科病理学家和 Mohs 外科医生在 cSCC 组织学分化分级中的组内和组间可靠性。
选择了 131 张存档切片。三名皮肤科病理学家和三名 Mohs 外科医生对肿瘤进行了盲法分级（第一轮）。为了提高一致性，所有 6 名参与者随后被要求根据设计的定量分级量表重新分级肿瘤（第二轮）。
第一轮的总体 κ 值为 0.56，对应弱一致性。高分化、中分化和低分化肿瘤的 κ 值分别为 0.68、0.39 和 0.59，对应中度、最小和弱一致性。在研究的第二轮中，总体 κ 值为 0.60，高分化、中分化和低分化肿瘤的 κ 值分别为 0.75、0.46 和 0.61。总体组内可靠性为 0.70（κ = 0.70、0.77、0.68、0.71、0.56 和 0.75），对应中度一致性。
实验组中 cSCC 组织学分级的总体一致性为弱到中度。在不同的组织学分化程度之间存在明显的一致性差异，中分化肿瘤的一致性最低。
