Tetu B, Hunt A, Mc Caughey W T, Lagace R
Ann Pathol. 1984 Sep-Nov;4(4):267-71.
Evaluation of observers variation in the histopathologic diagnosis of soft tissue tumors. 260 cases of soft tissue tumors referred to the CTRC (Canadian Tumour Reference Center) for diagnostic opinion were reviewed. These tumors were collected from 98 different hospitals within the 10 canadian provinces and had been submitted to a specialized panel of pathologists having a particular interest in this field. 22 tumors of nonmesenchymal origin have been discarded. The main problem posed by the contributors related to the histologic typing of overtly malignant and sarcomatous tumors (122/238). Comparing the diagnoses proposed by contributors and the panel, a consensus in term of benign and malignant tumor was reached in 89% of the cases. Within this panel, there was consensus in 84% of the cases. However, regarding the histologic typing, a consensus was reached between contributors and the panel in only 65% of the studied cases. Within the panel, there was a majority diagnosis in merely 62% of them. A mean of three different diagnoses were proposed for each case. A review of the literature shows that histologic typing of soft tissue tumors is of only limited prognostic significance. On the other hand, the clinical staging comprising histologic grade, size, depth, local growth and metastases is essential to establish prognosis and treatment. However, since certain tumors respond differently to treatment, a precise histopathologic diagnosis using immunohistochemistry and electron microscopy is mandatory.
软组织肿瘤组织病理学诊断中观察者间差异的评估。对提交给加拿大肿瘤参考中心（CTRC）以获取诊断意见的260例软组织肿瘤病例进行了回顾。这些肿瘤取自加拿大10个省内的98家不同医院，并已提交给对该领域有特殊兴趣的专业病理学家小组。22例非间叶源性肿瘤已被排除。提交者提出的主要问题与明显恶性和肉瘤性肿瘤的组织学类型有关（122/238）。将提交者和专家小组提出的诊断进行比较，在89%的病例中就良性和恶性肿瘤达成了共识。在该专家小组内部，84%的病例达成了共识。然而，关于组织学类型，在仅65%的研究病例中提交者和专家小组达成了共识。在专家小组内部，其中仅有62%的病例有多数诊断意见。每个病例平均提出了三种不同的诊断。文献回顾表明，软组织肿瘤的组织学类型仅具有有限的预后意义。另一方面，包括组织学分级、大小、深度、局部生长和转移情况的临床分期对于确定预后和治疗至关重要。然而，由于某些肿瘤对治疗的反应不同，使用免疫组织化学和电子显微镜进行精确的组织病理学诊断是必不可少的。
