Carey F A, Gray E, Salto-Tellez M, Kelly C, Dye R, Duvall E, Lamb D
Department of Pathology, University of Edinburgh.
J Clin Pathol. 1995 Jul;48(7):616-9. doi: 10.1136/jcp.48.7.616.
To describe a systematic investigation of interobserver differences in interpretation of nuclear morphology in preparations of small cell lung cancer (SCLC).
The screening/reviewing facility on the highly optimised microscope environment was used to individually tag 127 nuclei, chosen to reflect the spectrum of morphological appearances in nuclear preparations from three biopsy specimens of SCLC. Each nucleus was reviewed and labelled as control (lymphocyte), malignant or unsatisfactory by each of four observers. DNA histograms were plotted for each specimen using the nuclei identified as malignant by each participant. The histograms were compared in terms of identification of DNA stemlines and by calculation of a 5c exceeding rate (5cER).
Interobserver variation in assessment of morphology was seen in 55.1% of nuclei. Disagreement occurred most frequently in the malignant/unsatisfactory category. Differences in morphological classification had little influence on histogram assessment by means of visual inspection but did show an effect on 5cER.
There are significant interobserver differences in subjective assessment of nuclear morphology in cytometric preparations. This effect may seriously influence cytometric measurements.
描述一项关于小细胞肺癌（SCLC）标本中核形态学解读的观察者间差异的系统性研究。
利用高度优化的显微镜环境下的筛查/复查设施，对127个细胞核进行单独标记，这些细胞核选自3个SCLC活检标本的核标本，以反映核形态的光谱。4名观察者分别对每个细胞核进行复查并标记为对照（淋巴细胞）、恶性或不满意。使用每位参与者认定为恶性的细胞核为每个标本绘制DNA直方图。通过识别DNA干系和计算5c超标率（5cER）对直方图进行比较。
55.1%的细胞核存在观察者间形态学评估差异。分歧最常出现在恶性/不满意类别中。形态学分类的差异对通过目视检查进行的直方图评估影响不大，但对5cER有影响。
在细胞计数标本中，核形态学的主观评估存在显著的观察者间差异。这种影响可能会严重影响细胞计数测量。
