방광의 요로상피세포종양의 ISUP/WHO등급에 대한 연구
ISUP/WHO Classification of Papillary Urothelial Neoplasms of Urinary Bladder- Consensus Study Conducted by Korean Society of Urogenital Pathology -
심정원, 이동화, 노재윤, 조남훈, 박용욱, 한운섭, 김영식, 최영진, 심상인,
소속 상세정보
심정원 ( Shim Jung-Weon )
한림대학교 의과대학 병리학교실
이동화 ( Lee Dong-Wha )
순천향대학교 의과대학 병리학교실
노재윤 ( Ro Jae-Y. )
The Methodist 병원 병리과
조남훈 ( Cho Nam-Hoon )
연세대학교 의과대학 병리학교실
박용욱 ( Park Yong-Wook )
한양대학교 의과대학 병리학교실
한운섭 ( Han Woon-Sup )
이화여자대학교 의과대학 병리학교실
김영식 ( Kim Young-Sik )
고려대학교 의과대학 병리학교실
최영진 ( Choi Yeong-Jin )
가톨릭대학교 의과대학 병리학교실
심상인 ( Shim Sang-In )
가톨릭대학교 의과대학 병리학교실
KMID : 0357920060400040282
Abstract
Background: Pathologic grading, one of the most important prognostic factors of papillary urothelial neoplasia (PUN) of the urinary bladder, has been revised continuously. The current study focused on the analysis of interobserver agreement on PUN of the urinary bladder bet- ween 1973 WHO classification (WHO 1973) and 1998 WHO/ISUP classification.
Methods: Seventy five cases from 15 institutions were collected, and after review by Korean Society of Urogenital Pathology (KSUP), 30 cases were selected as follows; group I, WHO grade 1 and papillary urothelial neoplasm of low malignant potential by ISUP (7 cases), group II, WHO grade 2 and low-grade papillary urothelial carcinoma (16 cases), and group III, WHO grade 3 and high-grade papillary urothelial carcinoma (7 cases). Seventy five general surgical pathologists who participated in this study were asked to grade the tumors based on WHO/ISUP classification. Interobserver agreement between the participants’ diagnosis and KSUP consensus diagnosis was analyzed by kappa value.
Results: Interobserver agreement assessed by kappa value for all diagnostic groups was very low; for group I, kappa value was -0.900893722; for group II, -0.944650025, and for group III, -0.876728996. The overall kappa value of pathology residents was better than that of practicing pathologists.
Conclusions: The 1998 WHO/ ISUP classification could not be easily translated from the 1973 WHO classification and because of poor interobserver agreement, it appears that further work would be needed before it can be practically applied.
키워드
Bladder neoplasms;WHO classification;Transitional cell carcinoma
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