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首页> 外文期刊>Modern Pathology >Interobserver agreement and reproducibility in classification of invasive breast carcinoma: an NCI breast cancer family registry study
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Interobserver agreement and reproducibility in classification of invasive breast carcinoma: an NCI breast cancer family registry study

机译：观察者之间的共识和浸润性乳腺癌分类的可重复性：NCI乳腺癌家族登记研究

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The United States National Cancer Institute Breast/Ovarian Cancer Family Registry is the largest international Registry of this type; over 37724 individuals have been enrolled to date. One activity of this Registry is the semicentralized pathologic review of tumors from all probands. Given the semicentralized nature of the review, this study was undertaken to determine the reproducibility, source(s) of classification discrepancies and stratagems to circumvent discrepancies for histologic subtyping and grading of invasive breast cancer among the reviewing pathologists. A total of 13 pathologists reviewed 35 invasive breast cancers and classified them by primary and secondary histologic type, Nottingham grade and score. Lymph–vascular space invasion, circumscribed margins, syncytial growth and lymphocytic infiltrate were also evaluated. A training session using a separate set of slides was conducted prior to the study. General agreement, in terms of category-specific 's and percent agreement, and accuracy of classification relative to a reference standard were determined. Classification of histologic subtype was most consistent (and accurate) for mucinous carcinoma (=1.0), followed by tubular (=0.8) and lobular subtypes (=0.8). Classification of medullary subtype was moderate (=0.4), but additional evaluation of degree of lymphocytic infiltrate, syncytial growth and circumscribed margins identified most cases. Category-specific 's were moderate to good for Nottingham grade (=0.5–0.7), with the greatest agreement obtained in categorizing grade I (=0.7), and grade III tumors (=0.7). A flexible classification strategy that employs individual and combined criteria provides good interobserver agreement for invasive breast cancers with uniform, unambiguous histology and compensates for classification discrepancies in the more histologically ambiguous or heterogeneous cancers.
机译：美国国家癌症研究所乳腺癌/卵巢癌家庭注册系统是此类中最大的国际注册系统;迄今为止，已有37724多人报名参加。该注册中心的一项活动是对所有先证者的肿瘤进行半集中病理检查。考虑到评价的半集中性，本研究旨在确定评价病理学家之间的可复制性，分类差异的来源和策略，以规避侵入性乳腺癌的组织学亚型和分级的差异。共有13位病理学家回顾了35种浸润性乳腺癌，并按主要和次要的组织学类型，诺丁汉等级和评分对它们进行了分类。还评估了淋巴-血管间隙的浸润，切缘的界限，合胞体的生长和淋巴细胞的浸润。在研究之前，使用单独的幻灯片组进行了培训。确定了针对特定类别和百分比的通用协议，以及相对于参考标准的分类准确性。粘液癌的组织学亚型分类最一致（准确）（= 1.0），其次是肾小管（= 0.8）和小叶亚型（= 0.8）。髓样亚型的分类为中度（= 0.4），但大多数情况下对淋巴细胞浸润程度，合胞体生长和切缘的进一步评估可确定。对于诺丁汉等级（= 0.5–0.7），特定类别的肿瘤为中等到良好，在对I级（= 0.7）和III级肿瘤（= 0.7）进行分类中获得了最大的共识。灵活的分类策略采用个体和综合标准，为组织学一致，明确的浸润性乳腺癌提供了良好的观察者间共识，并弥补了组织学上较为歧义或异质的癌症中的分类差异。

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