Dundas S A, Kay R, Beck S, Cotton D W, Coup A J, Slater D N, Underwood J C
Department of Pathology, University of Sheffield Medical School.
J Clin Pathol. 1987 Nov;40(11):1282-6. doi: 10.1136/jcp.40.11.1282.
A copy of the standardised classification (SC) proposed for assessing dysplasia in inflammatory bowel disease was circulated to six histopathologists who were asked to apply it to 40 slides from 34 patients with ulcerative colitis to test its reproducibility. The slides were relabelled and recirculated to the pathologists at least one month later. Each was asked to state whether or not key diagnostic features were present before giving a final dysplasia score for the second assessment. Only minor interobserver and intraobserver disagreements were recorded. Pathologists were most consistent at recognising back to back glands, villous mucosal architecture, hyperchromatic nuclei, stratification of nuclei, regenerative nuclei and loss of nuclear polarity. There was poor interobserver agreement in assessing dystrophic goblet cells and columnar mucous cells. Back to back glands, hyperchromatic nuclei, loss of nuclear polarity, stratification of nuclei and columnar mucous cells were considered to be the most important features for determining the severity of dysplasia. As there was poor interobserver agreement in assessing columnar mucous cells and dystrophic goblet cells these features need to be more clearly defined or should be removed from the SC.
一份为评估炎症性肠病发育异常而提出的标准化分类（SC）副本分发给了六位组织病理学家，要求他们将其应用于来自34例溃疡性结肠炎患者的40张切片，以测试其可重复性。这些切片被重新标记，并在至少一个月后再次分发给病理学家。在给出第二次评估的最终发育异常评分之前，要求每位病理学家说明关键诊断特征是否存在。仅记录到了观察者间和观察者内的轻微分歧。病理学家在识别背靠背腺体、绒毛状黏膜结构、核深染、核分层、再生核和核极性丧失方面最为一致。在评估营养不良性杯状细胞和柱状黏液细胞时，观察者间的一致性较差。背靠背腺体、核深染、核极性丧失、核分层和柱状黏液细胞被认为是确定发育异常严重程度的最重要特征。由于在评估柱状黏液细胞和营养不良性杯状细胞时观察者间的一致性较差，这些特征需要更明确地定义，或者应从SC中删除。
