背景:由于皮肤病理学领域并不是一门精确的科学,它容易产生个人主观性,有时会导致对某些组织学特征的诊断和评估存在分歧。在黑色素瘤的情况下,一些变量,如回归与低观察者之间的一致性有关。相反,其他变量,如Breslow厚度的测量显示出高再现性。
目的:我们研究的主要目的是调查60例连续黑色素瘤的多个特征,以建立观察者间的可重复性。
结果:我们在Manises医院进行了一项观察性和描述性研究,瓦伦西亚,西班牙,IVO基金会,瓦伦西亚,西班牙,和12号医院,马德里,西班牙。所有研究变量的平均一致性水平中等(Cohen的kappa系数统计值=0.5)。最高的一致性对应于息肉形态,色素沉着,溃疡,和太阳弹性沉着症。另一方面,对于细胞多态性和肿瘤坏死的存在,达成了最低水平的协议。
结论:我们的平均协议水平中等,这反映了一些测量的特征,如细胞多态性或坏死的存在不能用于未来的研究或必须重新定义和再现性,重建。在进行研究时,有必要对研究变量进行分析,以证明其衡量或分类某一特征的有效性。还建议保证变量是可重复的,以便能够将它们用于其他研究或常规临床实践。
BACKGROUND: Since the field of dermatopathology is not an exact science, it is prone to personal subjectivity, which sometimes causes disagreements on the diagnosis and assessment of some histological features. In the
case of melanoma, some variables such as regression are associated with low interobserver agreement. On the contrary, other variables such as the measurement of Breslow thickness show high reproducibility.
OBJECTIVE: The main objective of our study was to investigate multiple features of 60 consecutive cases of melanoma to establish interobserver reproducibility.
RESULTS: We conducted an observational and descriptive study at Hospital de Manises, Valencia, Spain, IVO Foundation, Valencia, Spain, and Hospital 12 de Octubre, Madrid, Spain. The mean level of agreement of all study variables was moderate (Cohen\'s kappa coefficient statistic = 0.5). The highest agreement corresponded to polypoid morphology, pigmentation, ulceration, and solar elastosis. On the other hand, the lowest level agreement was reached for the presence of cellular pleomorphism and tumor necrosis.
CONCLUSIONS: Our mean level of agreement was moderate, which reflects that some of the measured characteristics such as cellular pleomorphism or the presence of necrosis cannot be used for future studies or must be redefined and their reproducibility, reestablished. When conducting a research study, it is necessary to analyze the study variables to demonstrate their validity to measure or classify a certain feature. It is also advisable to warrant that that the variables are reproducible to be able to use them for other studies or in the routine clinical practice.