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Nuclear grade and comedo necrosis of ductal carcinoma in situ as histopathological eligible criteria for the Japan Clinical Oncology Group 1505 trial: an interobserver agreement study.

核级和导管原位癌的粉刺坏死作为日本临床肿瘤学组1505试验的组织病理学合格标准: 观察者间一致性研究。

  • 影响因子:0
  • DOI:10.1093/jjco/hyaa235
  • 作者列表:"Tsuda H","Yoshida M","Akiyama F","Ohi Y","Kinowaki K","Kumaki N","Kondo Y","Saito A","Sasaki E","Nishimura R","Fujii S","Homma K","Horii R","Murata Y","Itami M","Kajita S","Kato H","Kurosumi M","Sakatani T","Shimizu S","Taniguchi K","Tamiya S","Nakamura H","Kanbayashi C","Shien T","Iwata H
  • 发表时间:2021-03-03
Abstract

OBJECTIVE:The Japan Clinical Oncology Group 1505 trial is a single-arm multicentre prospective study that examined the possibility of non-surgical follow-up with endocrine therapy for patients with low-grade ductal carcinoma in situ. In that study, the eligible criteria included histopathological findings comprising low to intermediate nuclear grade and absence of comedo necrosis, and cases were entered according to the local histopathological diagnosis. Nuclear grade is largely based on the Consensus Conference criteria (1997), whereas comedo necrosis is judged according to the Rosen's criteria (2017). The purpose of this study was to standardize and examine the interobserver agreement levels of these histopathological criteria amongst the participating pathologists. METHODS:We held slide conferences, where photomicrographs of haematoxylin-eosin-stained slides from 68 patients with ductal carcinoma in situ were presented using PowerPoint. The nuclear grade and comedo necrosis statuses individually judged by the pathologists were analysed using κ statistics. RESULTS:In the first and second sessions, where 22 cases each were presented, the interobserver agreement levels of nuclear grade whether low/intermediate grade or high grade were moderate amongst 29 and 24 participating pathologists, respectively (κ = 0.595 and 0.519, respectively). In the third session where 24 cases were presented, interobserver agreement levels of comedo necrosis or non-comedo necrosis were substantial amongst 25 participating pathologists (κ = 0.753). CONCLUSION:Although the concordance rates in nuclear grade or comedo necrosis were not high in a few of the cases, we believe that these results could provide a rationale for employing the present criteria of nuclear grade and comedo necrosis in the clinical study of ductal carcinoma in situ.

摘要

目的: 日本临床肿瘤学组1505试验是一项单臂多中心前瞻性研究,研究了对低级别导管原位癌患者进行内分泌治疗的非手术随访的可能性。在该研究中,合格的标准包括组织病理学发现,包括低到中等核级别和不存在粉刺坏死,并且根据局部组织病理学诊断输入病例。核级别主要基于共识会议标准 (1997),而粉刺坏死根据Rosen标准 (2017) 判断。本研究的目的是标准化和检查参与病理学家之间这些组织病理学标准的观察者间一致性水平。 方法: 我们举行了幻灯片会议,其中68例导管原位癌患者的苏木精-伊红染色幻灯片的显微照片使用PowerPoint呈现。使用 κ 统计量分析由病理学家单独判断的核级和粉刺坏死状态。 结果: 在第一和第二次会议中,各有22个病例,在29名和24名参与病理学家中,核等级的观察者间一致性水平 (κ 分别 = 0.595和0.519) 分别为中等。在提出24例病例的第三次会议中,25名参与病理学家 (κ = 0.753) 中粉刺坏死或非粉刺坏死的观察者间一致水平很大。 结论: 虽然在少数病例中,核分级或粉刺坏死的一致率不高,但我们认为这些结果可以为在导管原位癌的临床研究中采用目前的核分级和粉刺坏死标准提供理论依据。

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