Kappa分析在肝穿刺活检病理诊断质量控制中的应用

Application of kappa analysis in quality control of pathological diagnosis in liver biopsies

目的 用Kappa分析来检验和控制肝活检病理诊断的质量。 方法 把通常的肝活检病理诊断和本课题组所采用的 3名专家独立读片的方法用Kappa分析进行检验和比较。 结果 通常的肝活检病理诊断 ,肝脏炎症分级的最高Kappa值为 0 .4882 ,P <0 .0 0 0 1,一致性适中 ;肝纤维化分期的最高Kappa值为 0 .2 785 ,P =0 .0 0 0 3 ,但一致性较弱。采用 3名专家独立读片的方法 ,肝炎症分级的最小Kappa值为 0 .80 77,最大为 0 .986 3 ,P均小于 0 .0 0 0 1,平均值为 0 .9176 ,一致性最佳 ;肝纤维化分期最小的Kappa值为 0 .75 33 ,最大为 0 .912 7,P均小于 0 .0 0 0 1,平均值为 0 .814 4 ,一致性最佳。结论 采用 3名专家独立读片的方法 ,病理诊断质量极佳 ,可达到课题设计的要求。

Objective To test and control the quality of pathological diagnosis in liver biopsies by kappa analysis.Methods Kappa analysis was used to test and compare the two methods of pathological diagnosis in liver biopsies. Conventional method and the method of slide reviewing independently by three pathologists were adopted by this study group.Results By the conventional method the maximum kappa, value was 0.4882( P <0.0001), moderate in consistency for the grading of hepatic inflammation, and 0.2785 ( P =0.0003), weak in consistency for staging of liver fibrosis. In the method independently determined by three pathologists, the minimum kappa value was 0.8077 and the maximum was 0.9863 ( P <0.0001), the average value was 0.9176, excellent in consistency for the grading of hepatic inflammation; the minimum kappa value was 0.7533 and the maximum was 0.9172( P <0.0001), the average was 0.8144, excellent in consistency for the staging of liver fibrosis.Conclusion The quality of pathological diagnosis was excellent and could satisfy the demand of the research design.