Gantana Ethan, Mashigo Nomusa, Abdullah Ibtisam, Musekwa Ernest, Lohlun Robert, Nell Erica-Mari, Chetty Carissa, Ntobongwana Monalisa, Chapanduka Zivanai
Department of Haematology, National Health Laboratory Service, Tygerberg Hospital and Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa.
Department of Haematology, National Health Laboratory Service, Tygerberg Hospital and Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa
J Clin Pathol. 2023 Apr;76(4):261-265. doi: 10.1136/jclinpath-2021-207828. Epub 2021 Oct 8.
To compare the frequently used CD138 immunohistochemistry-based method of plasma cell quantitation, to a proposed new method, using interobserver and intraobserver concordance parameters.
Archival CD138 immunohistochemically stained slides made from paraffin-embedded bone marrow biopsies of 33 patients with a confirmed diagnosis of multiple myeloma were used. Light microscopic examination was performed using low magnification lenses (10×) for both the overview estimation method (method A) and the new method (method B), and high magnification lenses (50×), for method B only. For method B, reviewers selected three areas with low, intermediate and high plasma cell densities using 10× lenses. Using a well-defined technique, the 50× lens was then used to count plasma cells as a percentage of all nucleated cells. After blinded relabelling of all the slides, the nine reviewers repeated the plasma cell quantitation using both methods. The plasma cell counts were obtained, and the review times were recorded.
Overall intraobserver concordance was comparable for method A (concordance correlation coefficient (CCC)=0.840) and method B (CCC=0.733). Interobserver concordance for method A (intraclass correlation coefficient (ICC)=0.793 and 0.713) and method B (ICC=0.657 and 0.658) indicated high similarity between reviewers. Method A showed poor interobserver concordance (ICC=0.105) at low plasma cell densities.
The new method is comparable to the frequently used overview estimation method in terms of intraobserver and interobserver concordance, and cost. The new method has superior interobserver concordance at low plasma cell densities. The new method appears more amenable to digital scanning and analysis.
使用观察者间和观察者内一致性参数，比较常用的基于CD138免疫组织化学的浆细胞定量方法与一种新提出的方法。
使用33例确诊为多发性骨髓瘤患者石蜡包埋骨髓活检组织制成的存档CD138免疫组织化学染色玻片。采用低倍镜（10×）对总体评估方法（方法A）和新方法（方法B）进行光学显微镜检查，方法B仅使用高倍镜（50×）。对于方法B，观察者使用10×镜头选择三个浆细胞密度低、中、高的区域。然后使用明确的技术，用50×镜头对浆细胞作为所有有核细胞的百分比进行计数。在对所有玻片进行盲法重新标记后，九名观察者使用两种方法重复浆细胞定量。获得浆细胞计数，并记录观察时间。
方法A（一致性相关系数（CCC）=0.840）和方法B（CCC=0.733）的总体观察者内一致性相当。方法A（组内相关系数（ICC）=0.793和0.713）和方法B（ICC=0.657和0.658）的观察者间一致性表明观察者之间具有高度相似性。方法A在低浆细胞密度时观察者间一致性较差（ICC=0.105）。
新方法在观察者内和观察者间一致性以及成本方面与常用的总体评估方法相当。新方法在低浆细胞密度时具有更好的观察者间一致性。新方法似乎更适合数字扫描和分析。
