Mierau G W, Berry P J, Malott R L, Weeks D A
Department of Pathology, Children's Hospital Denver, CO 80218, USA.
Ultrastruct Pathol. 1996 Nov-Dec;20(6):507-17. doi: 10.3109/01913129609016355.
To provide an objective assessment of the comparative utility of fluorescence- and peroxidase-based immunohistochemistry and electron microscopy, an observer blinded study was conducted under realistic study conditions utilizing a large sampling of poorly differentiated pediatric round cell tumors. Working independently, using a single ancillary technique of particular expertise, each of three investigators attempted to render a specific diagnosis with regard to 50 diagnostically challenging tumors. The results were compared against the subsequent "file diagnosis" established by consensus with all relevant information made available. A grading scheme was applied wherein points were awarded based on the accuracy and confidence of diagnosis. A comparative efficiency rating, expressed as a percentage, was formulated by dividing the number of points awarded each technique by the total number of points theoretically available. Electron microscopy proved superior overall, with an efficiency rating of 89%. Immunoperoxidase and immunofluorescence studies yielded efficiency ratings of 71 and 61%, respectively. Used in combination, the techniques achieved an efficiency rating of 95%. Application of these ancillary techniques resulted in a revision of the provisional diagnosis in 11 of 50 cases, and left only two cases without a firm specific diagnosis.
为了对基于荧光和过氧化物酶的免疫组织化学及电子显微镜检查的相对效用进行客观评估，在实际研究条件下，利用大量低分化小儿圆形细胞肿瘤样本进行了一项观察者盲法研究。三位研究者各自独立工作，运用一项具有特定专业知识的辅助技术，尝试对50例具有诊断挑战性的肿瘤做出明确诊断。将结果与随后通过综合所有相关可用信息达成共识确定的“档案诊断”进行比较。应用一种评分方案，根据诊断的准确性和可信度来打分。通过将每种技术获得的分数除以理论上可得的总分，得出以百分比表示的相对效率评级。总体而言，电子显微镜检查表现更优，效率评级为89%。免疫过氧化物酶和免疫荧光研究的效率评级分别为71%和61%。这些技术联合使用时，效率评级达到95%。应用这些辅助技术导致50例病例中有11例的初步诊断得到修订，仅剩下2例未得到明确的具体诊断。
