Abstract：
Canine meningiomas are currently graded using the human grading system. Recently published guidelines have adapted the human grading system for use in dogs. The goal of this study was to validate the new guidelines for canine meningiomas. To evaluate the inter-observer agreement, 5 veterinary surgical pathologists graded 158 canine meningiomas following the human grading system alone or with the new guidelines. The inter-observer agreement for histologic grade and each of the grading criteria (mitotic grade, invasion, spontaneous necrosis, macronucleoli, small cells, hypercellularity, pattern loss and anaplasia) was evaluated using the Fleiss kappa index. The diagnostic accuracy (sensitivity and specificity) was assessed by comparing the diagnoses obtained with the 2 grading systems with a consensus grade (considered the reference classification). The consensus histologic grade was obtained by agreement between 4 experienced veterinary neuropathologists following the guidelines. Compared with the human grading alone, the canine-specific guidelines increased the inter-observer agreement for: histologic grade (κ = 0.52); invasion (κ = 0.67); necrosis (κ = 0.62); small cells (κ = 0.36); pattern loss (κ = 0.49) and anaplasia (κ = 0.55). Mitotic grade agreement remained substantial (κ = 0.63). The guidelines improved the sensitivity in identifying grade 1 (95.6%) and the specificity in identifying grade 2 (96.2%) meningiomas. In conclusion, the new grading guidelines for canine meningiomas are associated with an overall improvement in the inter-observer agreement and higher diagnostic accuracy in diagnosing grade 1 and grade 2 meningiomas.
摘要：
目前使用人类分级系统对犬脑膜瘤进行分级。最近发布的指南已经调整了用于狗的人类分级系统。这项研究的目的是验证犬脑膜瘤的新指南。为了评估观察员之间的协议，5名兽医外科病理学家根据人类分级系统单独或根据新指南对158例犬脑膜瘤进行分级。组织学分级和每个分级标准(有丝分裂分级，入侵,自发性坏死,大核,小细胞,细胞过多,模式丢失和发育不良）使用Fleisskappa指数进行评估。通过比较2个分级系统获得的诊断与一致等级(考虑参考分类)来评估诊断准确性(灵敏度和特异性)。根据指南，4位经验丰富的兽医神经病理学家之间达成共识，获得了一致的组织学等级。与人类单独分级相比，犬特异性指南增加了观察者之间的一致性：组织学分级（κ=0.52）;侵袭（κ=0.67）;坏死（κ=0.62）;小细胞（κ=0.36）;模式丢失（κ=0.49）和间变（κ=0.55）。有丝分裂等级一致性仍然很大（κ=0.63）。该指南提高了识别1级脑膜瘤的敏感性（95.6％）和识别2级脑膜瘤的特异性（96.2％）。总之,新的犬脑膜瘤分级指南与在1级和2级脑膜瘤诊断中观察者间一致性的整体改善和更高的诊断准确性相关.
