Comparison of the interobserver reproducibility with different histologic criteria used in celiac disease

被引:210
作者
Corazza, Gino Roberto
Villanacci, Vincenzo
Zambelli, Claudia
Milione, Massimo
Luinetti, Ombretta
Vindigni, Carla
Chioda, Caterina
Albarello, Luca
Bartolini, Daniela
Donato, Francesco
机构
[1] Univ Pavia, Dept Med 1, Fondazione Policlin S Matteo, I-27100 Pavia, Italy
[2] Univ Brescia, Dept Pathol 2, Brescia, Italy
[3] Univ Roma La Sapienza, S Andrea Hosp, Dept Pathol, Rome, Italy
[4] Univ Pavia, Dept Pathol, Fondazione Policlin S Matteo, I-27100 Pavia, Italy
[5] Univ Siena, Dept Human Pathol & Oncol, I-53100 Siena, Italy
[6] Osped Mellino Mellini Chiari, Dept Pathol, Brescia, Italy
[7] IRCCS S Raffaele, Dept Pathol, Milan, Italy
[8] Osped Maurizio Bufalini, Dept Pathol, Cesena, Italy
[9] Univ Brescia, Inst Hyg Epidemiol & Publ Hlth, Brescia, Italy
关键词
INTESTINAL BIOPSY; SPECIMENS; AGREEMENT; DIAGNOSIS; SPRUE; TIME;
D O I
10.1016/j.cgh.2007.03.019
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background & Aims: The Marsh-Oberhuber classification of duodenojejunal mucosal lesions is currently used for celiac disease. A more simplified classification, which is based on 3 villous morphologies (A, non-atrophic; B1, atrophic, villous-crypt ratio <3:1; B2, atrophic, villi no longer detectable) and an intraepithelial lymphocyte count of >25/100 enterocytes, has recently been proposed. The aim of the study was to asses the interobserver agreement between different pathologists in classifying celiac disease lesions according to both Marsh-Oberhuber and the new classification system. Methods: Sixty patients were selected for the study: 10 subjects without celiac disease, 13 celiac patients with normal villi but a pathologic increase in intraepithelial lymphocytes >25/100 and hyperplastic crypts, and 37 patients with celiac disease with villous atrophy. Sixty slides were sent to 6 pathologists, who were blinded to each other and were not given any clinical information. Each pathologist received the set of biopsy specimens on 2 separate occasions and had to evaluate them according to both grading systems in a random order. The kappa statistic was used to assess agreement between each pair of pathologists. Results: Overall, mean kappa values were 0.35 (fair) for the Marsh-Oberhuber classification versus 0.55 (moderate) for the new classification system. Conclusions: The new classification for duodenal pathology in celiac disease gives better interobserver agreement compared with the more cumbersome Marsh-Oberhuber classification and contributes to the validity of diagnosis in celiac disease.
引用
收藏
页码:838 / 843
页数:6
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