Sun D Q, Feng C H, Böcking A, Biesterfeld S
Department of Orthopedics, Medical University, Beijing, People's Republic of China.
Anticancer Res. 1994 Jul-Aug;14(4A):1525-8.
The insufficient interobserver reproducibility limits the practical use of histomorphological tumor grading in daily routine pathology. In this study, the reasons for the quite low rates of agreement between different observers have been investigated by the application of a factor analytical technique, i.e. principal component analysis with varimax rotation, on a tumor grading system. Grading results from 44 cases of G1 and G2 giant cell tumors of the bone (GCT), graded by three different observers according to the five criteria of Jaffe, were taken as an example. It could be proven that the single criteria were used in an observer-specific way. Two criteria, for example, which are scored highly correlated by one observer, may be used independently by another. The resulting observer-specific different recognition patterns may provide an explanation for their quite different grading results, which were identical in only 48.6% to 54.1% (mean: 50.9%) of the cases. No correlation of GCT grading with recurrence was found in 31 cases which had been treated by intralesional surgery.
观察者间重复性不足限制了组织形态学肿瘤分级在日常病理诊断中的实际应用。在本研究中，通过对肿瘤分级系统应用因子分析技术，即具有方差最大化旋转的主成分分析，来探究不同观察者之间一致性率相当低的原因。以44例骨巨细胞瘤（GCT）的分级结果为例，这44例G1和G2级骨巨细胞瘤由三位不同观察者根据Jaffe的五项标准进行分级。结果表明，单一标准的使用存在观察者特异性。例如，一位观察者认为评分高度相关的两个标准，另一位观察者可能会独立使用。由此产生的观察者特异性不同识别模式可能解释了他们截然不同的分级结果，在这些病例中，只有48.6%至54.1%（平均：50.9%）的病例分级结果相同。在31例行病灶内手术治疗的病例中，未发现GCT分级与复发之间存在相关性。
