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首页> 外文期刊>Pathology International >Application of a new histological staging and grading system for primary biliary cirrhosis to liver biopsy specimens: Interobserver agreement.
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Application of a new histological staging and grading system for primary biliary cirrhosis to liver biopsy specimens: Interobserver agreement.

机译：新的组织学分期和分级系统在原发性胆汁性肝硬化在肝活检标本中的应用：观察者协议。

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Recently the authors proposed a new staging and grading system for primary biliary cirrhosis (PBC) that takes into account necroinflammatory activity and histological heterogeneity. Herein is proposed a convenient version of this system. Scores for fibrosis, bile duct loss, and chronic cholestasis were combined for staging: stage 1, total score of 0; stage 2, score 1-3; stage 3, score 4-6; and stage 4, score 7-9. Cholangitis activity (CA) and hepatitis activity (HA) were graded as CA0-3, and HA0-3, respectively. Analysis of interobserver agreement was then conducted. Digital images of 62 needle liver biopsy specimens of PBC were recorded as virtual slides on DVDs that were sent to 28 pathologists, including five located overseas. All participants were able to apply this version in all 62 cases. For staging, kappa was 0.385 (fair agreement) and the concordance rate was 63.9%. For necroinflammatory activity, the kappa and concordance rate were 0.110 (slight agreement) and 36.9% for CA, and 0.197 (slight agreement) and 47% for HA, respectively. In conclusion, this new staging and grading system for PBC seems to be more convenient and practical than those used at present, but more instruction and guidance are recommended for the grading of necroinflammatory activity in practice.
机译：最近，作者们提出了一种针对原发性胆汁性肝硬化（PBC）的新分期和分级系统，该系统考虑了坏死性炎症活动和组织学异质性。本文提出了该系统的方便版本。将纤维化，胆总管丢失和慢性胆汁淤积的得分进行分期：第一阶段，总得分为0;第二阶段，得分1-3;第三阶段，得分4-6;第四阶段，得分7-9。胆管炎活动（CA）和肝炎活动（HA）分别分级为CA0-3和HA0-3。然后进行了观察者间协议的分析。将62份PBC肝穿刺活检标本的数字图像记录为DVD上的虚拟幻灯片，然后将其发送给28位病理学家，其中包括5位位于海外的病理学家。所有参与者都能够在所有62个案例中应用此版本。分阶段看，kappa为0.385（公平协议），一致性率为63.9％。就坏死性炎症活性而言，CA的κ和一致性比率分别为0.110（轻微一致）和36.9％，而HA分别为0.197（轻微一致）和47％。总之，这种新的PBC分期和分级系统似乎比目前使用的系统更加方便和实用，但是建议在实践中对坏死性炎症分级进行更多的指导和指导。

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