Grading and scoring in histopathology

In many areas of histopathology a nominal category, such as a diagnosis of breast carcinoma, does not give enough information for the referring clinician to make decisions about patient prognosis and treatment. Therefore scoring and grading systems have been developed which provide additional information. This article reviews the principles behind these systems with particular reference to the relationships between the natural clustering (or nonclustering) of cases and the imposition of arbitrary class boundaries on such distributions. The difference between real numbers and the ordinal categorical numeric labels, which are often produced by histopathology scoring systems, is discussed. The reproducibility of scoring and grading systems is reviewed and generic suggestions are given for developing new systems and for their validation.

[1]  Mild abnormalities in liver histology associated with chronic hepatitis: distinction from normal liver histology. , 1997, Journal of clinical pathology.

[2]  Rippey.  Why classify basal cell carcinomas? , 1998, Histopathology.

[3]  Fiedler,et al.  Liver biopsy is a useful predictor of response to interferon therapy in chronic hepatitis C , 1998, Histopathology.

[4]  P. Silcocks.  Some issues in observer error studies in pathology. , 1992, The Journal of pathology.

[5]  P. Scheuer.  Chronic hepatitis: what is activity and how should it be assessed? , 1997, Histopathology.

[6]  S. Cross,et al.  Estimating mitotic activity in tumours , 1996, Histopathology.

[7]  F. B. Sørensen,et al.  Qualitative and quantitative histopathology in transitional cell carcinomas of the urinary bladder. An international investigation of intra- and interobserver reproducibility. , 1994, Laboratory investigation; a journal of technical methods and pathology.

[8]  N. Smeeton,et al.  Assessment of dysplasia in colorectal adenomas: an observer variation and morphometric study. , 1985, Journal of clinical pathology.

[9]  P. Silcocks,et al.  Measuring repeatability and validity of histological diagnosis--a brief review with some practical examples. , 1983, Journal of clinical pathology.

[10]  S S Cross,et al.  Kappa statistics as indicators of quality assurance in histopathology and cytopathology. , 1996, Journal of clinical pathology.

[11]  M F Dixon,et al.  Observer variation in the histological grading of rectal carcinoma. , 1983, Journal of clinical pathology.

[12]  N. Shepherd,et al.  Colorectal cancer reporting: are we failing the patient? , 1997, Journal of clinical pathology.

[13]  J. Baak,et al.  HETEROGENEITY OF MITOTIC ACTIVITY IN BREAST CANCER , 1996, Histopathology.

[14]  R. Blamey,et al.  A prognostic index in primary breast cancer. , 1982, British Journal of Cancer.

[15]  J A Morris,et al.  Information and observer disagreement in histopathology , 1994, Histopathology.

[16]  I. Ellis,et al.  Prognostic factors in primary breast carcinoma. , 1995, Journal of clinical pathology.

[17]  R W Blamey,et al.  Prognostic factors in breast cancer -- the formation of a prognostic index. , 1979, Clinics in oncology.

[18]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[19]  E. Foucar.  Do pathologists play dice? Uncertainty and early histopathological diagnosis of common malignancies , 1997, Histopathology.

[20]  R. Newcombe,et al.  Reporting cervical intra‐epithelial neoplasia (CIN): Intra‐ and interpathologist variation and factors associated with disagreement , 1990, Histopathology.

[21]  K. Ishak,et al.  Histological grading and staging of chronic hepatitis. , 1995 .

[22]  A J Robertson,et al.  Observer variability in the histopathological reporting of needle biopsy specimens of the prostate. , 1997, Human pathology.