Консенсус как способ оценки воспроизводимости диагноза интраэпителиальной неоплазии/дисплазии слизистой оболочки желудка: возможности использования в процессе непрерывного профессионального образования врачей-патологоанатомов

2018 
The reproducibility of the Modified Vienna classification of gastrointestinal neoplasia on the gastric mucosal biopsies was evaluated by using the kappa statistic. The work of a group of pathologists-experts was organized in the remote access mode with a demonstration of 26 cases (98 microphotographs) and an evaluation of the diagnostic category of gastric intraepithelial neoplasia/dysplasia. Different levels of agreement between the opinions of the participating experts have been established in depending on the diagnostic difficulty level. The kappa level ranged from 0.2 (poor agreement) to 0.66 (good agreement) and was depending from the chosen method of correction of the result. , This circumstance contributed to the formation of opinion that the diagnoses indefinite neoplasia/dysplasia-low and high grade neoplasia/dysplasia were the most difficult decisions. Possible reasons which reduce the level of consistency of pathologists are discussed.
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