Jacques J, Hill D P, Shier K J, Jindani A, Miller A B
Can Med Assoc J. 1980 Apr 19;122(8):897-901.
The 1967 World Health Organization (WHO) classification of the histologic types of lung tumours has been examined in relation to 303 tumours of patients admitted to a national trial of the treatment of lung cancer. In 63 instances (20%) there was disagreement between the diagnoses of the local pathologist and the reference pathologist. The slides for these 63 tumours were reviewed by two other pathologists, and the slides for 60 tumours for which there was agreement between the local and reference pathologists were reviewed by one of the other pathologists. The main disagreement was in the diagnosis of epidermoid (squamous) tumours. It is apparent that many pathologists do not adhere to the strict criterion of the presence of keratinization or intercellular prickles or both for the diagnosis of epidermoid carcinoma. In addition, there was substantial variation in the use of subtypes within the WHO classification. Use of the revised classification proposed by the WHO would have removed a small amount of the variation from these findings but would not have affected the main discrepancy. Stricter attention to the definition of types is required for a uniform approach to the histologic classification of lung tumours.
对1967年世界卫生组织（WHO）的肺肿瘤组织学类型分类，在参与一项全国性肺癌治疗试验的303例患者的肿瘤中进行了检验。在63例（20%）病例中，当地病理学家与参考病理学家的诊断存在分歧。这63例肿瘤的切片由另外两位病理学家进行了复查，另外，当地和参考病理学家诊断一致的60例肿瘤的切片由其中一位病理学家进行了复查。主要分歧在于表皮样（鳞状）肿瘤的诊断。显然，许多病理学家在诊断表皮样癌时未遵循存在角化或细胞间棘突或两者皆有的严格标准。此外，在WHO分类中各亚型的使用存在很大差异。采用WHO提议的修订分类会减少这些结果中的少量差异，但不会影响主要差异。为实现肺肿瘤组织学分类的统一方法，需要更严格地关注类型的定义。
