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首页> 外文期刊>Human Pathology >Interobserver agreement for Polyomavirus nephropathy grading in renal allografts using the working proposal from the 10th Banff Conference on Allograft Pathology.
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Interobserver agreement for Polyomavirus nephropathy grading in renal allografts using the working proposal from the 10th Banff Conference on Allograft Pathology.

机译：使用第十届班夫同种异体移植病理学会议的工作建议，为多瘤病毒肾病在同种异体肾中分级的观察者间协议。

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摘要

A classification schema for grading Polyomavirus nephropathy was proposed at the 2009 Banff allograft meeting. The schema included 3 stages of Polyomavirus nephropathy: early (stage A), florid (stage B), and late sclerosing (stage C). Grading categories for histologic viral load levels were also proposed. To examine the applicability and the interobserver agreement of the proposed Polyomavirus nephropathy grading schema, we evaluated 24 renal allograft biopsies with confirmed Polyomavirus nephropathy by histology and SV40. Four renal pathologists independently scored the Polyomavirus nephropathy stage (A, B, or C), without knowledge of the clinical history. Viral load was scored as a percent of tubules exhibiting viral replication, using either a 3-tier viral load score (1: 1%-10%; 3: >10%) or a 4-tier score (1: 1%-5%-15%; 4: >15%). The kappa score for the Polyomavirus nephropathy stage was 0.47 (95% confidence interval, 0.35-0.60; P < .001). There was a substantial agreement using both the 3-tier and the 4-tier scoring for the viral load (Kendall concordance coefficients, 0.72 and 0.76, respectively; P < .001 for both). A better complete agreement was found using the 3-tier viral load score. In this first attempt to evaluate the interobserver reproducibility of the proposed Polyomavirus nephropathy classifying schema, we demonstrated moderate kappa agreement in assessing the Polyomavirus nephropathy stage and a substantial agreement in scoring the viral load level. The proposed grading schema can be applied in routine allograft biopsy practice for grading the Polyomavirus nephropathy stage and the viral load level.
机译：在2009年班夫同种异体移植会议上提出了用于对多瘤病毒肾病分级的分类方案。该方案包括3个阶段的多瘤病毒肾病：早期（A期），小花（B期）和晚期硬化（C期）。还提出了组织学病毒载量水平的分级类别。为了检查提议的多瘤病毒肾病分级方案的适用性和观察者之间的共识，我们通过组织学和SV40评估了24例经证实的多瘤病毒肾病的肾脏同种异体移植活检。四名肾脏病理学家在不了解临床病史的情况下独立评分了多瘤病毒肾病阶段（A，B或C）。病毒载量使用三级病毒载量评分（1： 1％-10％; 3：> 10％）或4-级病毒表现为复制的小管百分比等级评分（1： 1％- 5％-15％; 4：> 15％）。多瘤病毒肾病阶段的kappa评分为0.47（95％置信区间为0.35-0.60; P <0.001）。对于病毒载量，使用3层和4层评分均达成了实质性共识（Kendall一致性系数分别为0.72和0.76;两者均P <0.001）。使用3层病毒载量评分，可以找到更好的完整协议。在评估提议的多瘤病毒肾病分类方案的观察者间可重复性的首次尝试中，我们在评估多瘤病毒肾病阶段时表现出适度的kappa一致性，在评估病毒载量水平方面表现出实质性的一致性。拟议的分级方案可用于常规同种异体移植活检实践中，以分级多瘤病毒肾病阶段和病毒载量水平。

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