Zhu Tian, Guffey Darren, Novicoff Wendy, Hendrix John
J Drugs Dermatol. 2023 Feb 1;22(2):190-194. doi: 10.36849/JDD.7084.
Mohs surgeons routinely encounter squamous cell carcinoma at surgical margins and often base the decision to take another layer on the severity of atypia observed. Currently, no criteria exists for distinguishing borderline histological patterns that could be interpreted differently as actinic keratosis (AK), squamous cell carcinoma in situ (SCCIS), or AK with focal SCCIS.
To assess interrater concordance amongst Mohs surgeons in distinguishing AK from SCCIS when evaluating Mohs frozen sections.
Seventeen slides were selected and converted into digitally formatted cases. They were compiled into an electronic survey and distributed to the American College of Mohs Surgery.
Overall κ was 0.26 corresponding to weak agreement between raters compared to the standard, with κ of 0.34 for AK and 0.37 for SCCIS.
There exists notable variability among Mohs surgeons who interpret the spectrum of in situ carcinoma differently. Ongoing learning and consensus building among Mohs surgeons and trainees can aid in quality patient care, even if there may not be agreement on every case. J Drugs Dermatol. 2023;22(2):199-194. doi:10.36849/JDD.7084.
莫氏外科医生在手术切缘经常遇到鳞状细胞癌，并且通常根据观察到的异型性严重程度来决定是否再切一层。目前，尚无区分临界组织学模式的标准，这些模式可能被不同地解释为光化性角化病（AK）、原位鳞状细胞癌（SCCIS）或伴有局灶性SCCIS的AK。
评估莫氏外科医生在评估莫氏冰冻切片时区分AK和SCCIS的评分者间一致性。
选择17张玻片并转换为数字格式的病例。将它们汇编成电子调查问卷并分发给美国莫氏外科学会。
总体κ值为0.26，与标准相比，评分者之间的一致性较弱，AK的κ值为0.34，SCCIS的κ值为0.37。
在对原位癌谱有不同解释的莫氏外科医生中存在显著差异。即使在每个病例上可能无法达成一致，但莫氏外科医生和学员之间持续的学习和建立共识有助于提供高质量的患者护理。《药物皮肤病学杂志》。2023年；22（2）：199 - 194。doi:10.36849/JDD.7084 。
需注意，原文中“199 - 194”可能有误，正常应是从小到大排列，这里按照原文进行了翻译。
