Conran R M, Hitchcock C L, Popek E J, Norris H J, Griffin J L, Geissel A, McCarthy W F
Department of Pediatric Pathology, Armed Forces Institute of Pathology, Washington, DC 20306.
Hum Pathol. 1993 Jan;24(1):41-8. doi: 10.1016/0046-8177(93)90061-k.
Hydatidiform moles (HMs) are classified as partial or complete based on a combination of gross, histologic, and karyotypic features. Adherence to strict and reproducible diagnostic criteria is needed to ensure accurate diagnosis and minimize interpathologist variability. Using the kappa statistic as a measure of agreement, the morphologic, flow cytometric, and clinical features of 80 cases of HM or suspected HM were analyzed sequentially by three pathologists to evaluate intrapathologist and interpathologist variability. Poor interpathologist agreement was obtained when histology alone was used for diagnosis. The combination of gross morphology and histology resulted in poor to good agreement. Good interpathologist agreement was obtained, however, when objective data (DNA content determined by flow cytometry) were included in the analysis. Our data indicate that pathologist concordance is maximized when the diagnosis is based on a combination of morphology and DNA content.
葡萄胎（HMs）根据大体、组织学和核型特征的组合分为部分性或完全性。需要遵循严格且可重复的诊断标准以确保准确诊断并尽量减少病理学家之间的差异。以kappa统计量作为一致性的衡量标准，三位病理学家依次分析了80例葡萄胎或疑似葡萄胎的形态学、流式细胞术和临床特征，以评估病理学家内部和病理学家之间的差异。仅使用组织学进行诊断时，病理学家之间的一致性较差。大体形态学和组织学的结合导致一致性从差到好。然而，当分析中纳入客观数据（通过流式细胞术测定的DNA含量）时，病理学家之间获得了良好的一致性。我们的数据表明，基于形态学和DNA含量的组合进行诊断时，病理学家的一致性最高。
