Interobserver reproducibility of Gleason grading of prostatic carcinoma: General pathologists

被引:288
作者
Allsbrook, WC
Mangold, KA
Johnson, MH
Lane, RB
Lane, CG
Epstein, JI
机构
[1] Med Coll Georgia, Sch Med, Dept Pathol, Augusta, GA 30912 USA
[2] Med Coll Georgia, Off Biostat, Augusta, GA 30912 USA
[3] Johns Hopkins Med Inst, Dept Pathol, Baltimore, MD 21205 USA
[4] Johns Hopkins Med Inst, Dept Urol, Baltimore, MD 21205 USA
[5] Johns Hopkins Med Inst, Dept Oncol, Baltimore, MD 21205 USA
关键词
prostatic neoplasms; prostatic carcinoma; prostatic adenocarcinoma; grading; Gleason grading; interobserver reproducibility;
D O I
10.1053/hupa.2001.21135
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Only a few large studies of interobserver reproducibility of Gleason grading of prostatic carcinoma exist. Thirty-eight biopsies containing prostate cancer were distributed for Gleason grading to 41 general pathologists in Georgia. These cases had "consensus" Gleason grade groups (2-4, 5-6, 7, and 8-10) that were agreed on by at least 7 of 10 urologic pathologists. The overall kappa (kappa) coefficient for interobserver agreement for these 38 cases was 0.435, barely moderate agreement, with a kappa range from 0.00 to 0.88. There was consistent undergrading of Gleason scores 5-6 (47%), 7 (47%) and, to a lesser extent, 8-10 (25%). In cases with consensus primary patterns, there was consistent undergrading of patterns 2 (32%), 3 (39%), and 5 (30%). Pattern 2 was often (17%) mistaken for pattern 3. Pattern 4 was often undergraded (21%) and also mistaken for pattern 5 (17%). The most significant (P < .005) demographic factor associated with better interobserver agreement was having learned Gleason grading at a meeting or course. We believe that Gleason grading can be learned to a satisfactory level of interobserver reproducibility and have undertaken additional studies that support this Copyright (C) 2001 by W.B. Saunders Company.
引用
收藏
页码:81 / 88
页数:8
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