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TRANSPLANT BÖBRE K İĞNE BİOPSİLERİNDE İKİ BİOPSİ KORU, İKİ SINIFLAMA (BANFF 97 VE CCTT) VE İKİ ARAŞTIRICI ARASINDAKİ TANI UYUMU

CONCORDANCE OF TWO CORES, TWO CLASSIFICATIONS (BANFF 97 AND CCTT ) AND TWO RESEARCHERS' DIAGNOSIS IN RENAL ALLOGRAFT NEEDLE BIOPSES

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Histological diagnosis and grading of acute renal allograft rejection does not always correlate with the clinical course and response to treatment. This may be due to inadequate sampling. But lack of objectivity in histological criteria used for diagnosis and grading causes a lack of understanding between pathologists. This may be a confounding factor as well. In this study, we compared the objectivity of the criteria of Banff classification (1997) and CCTT system and also searched concordance of histopathological findings between the biopsy cores. Two independent observers, unaware of each other, other core and clinical course or original histological diagnosis, reviewed slides of 170 cores of 85 renal allograft biopsies from 65 cases. Each core had been assessed for the absence or presence and type of rejection by using Banff 97 and CCTT classification. Between the two observers; the agreement rate, kappa and weighted kappa values were found respectively %84, 0.62 and 0.59 for Banff 97 classification and %o79, 0.54 and 0.58 for CCTT classification. The concordance of two cores, kappa and weighted kappa values were found respectively %81, 0.61 and 0.56. Reproducibility of both classifications, histologically was near the same. Obtaining two cores of biopsy is essential for a reliable diagnosis. However mentioning sensitivity and specificity rates between two classifications require some further studies which include comparative knowledge of clinical diagnose, respond to treatment and course.
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Abstract (Original Language): 
Akut rejeksiyonun histolojik tanı ve derecelendirmesi, her zaman klinik seyir ve tedaviye yanıt ile uyumlu olmamaktadır. Bu yetersiz örneklemeye bağlı olabilir. Ancak tanı ve derecelendirmede kullanılan histopatolojik bulguların objektif olmaması da, patologlar arasında farklılıklara neden olarak buna katkıda bulunabilir. Bu çalışmada Banff 97 klasifikasyonu ile CCTT sistemi kriterlerinin objektifliği ve biyopsi korları arasındaki histopatolojik bulguların uyumunu karşılaştırdık. iki bağımsız gözlemci birbirlerinden, diğer kordan, klinik seyir ve orijinal tanıdan habersiz olarak 65 hastadan alınan, 85 biyopsiye ait, 170 biyopsi korunu yeniden inceledi. Banff 97 ve CCTT klasifikasyonları kullanılarak akut rejeksiyon varlığı veya yokluğu ile rejeksiyon tipi belirlendi. İki araştırıcı arasındaki uyum, kappa ve ağırlıklı kappa değerleri sırasıyla Banff klasifikasyonu için %84, 0.62 ve 0.59, CCTT için %79, 0.54 ve 0.58 olarak bulundu. İki kor arasındaki uyum %81, kappa ve ağırlıklı kappa değerleri 0.61 ve 0.56'ydı. Sonuç olarak her iki sınıflamanın uygulanabilirliği birbirine yakındır. Güvenilir tanı için iki kor biopsi alınması gereklidir. İki sistemin duyarlılılığı ve spesifıkliğinden bahsedebilmek için karşılaştırmalı olarak klinik tanı, tedaviye yanıt ve prognozu içeren daha ileri çalışmalara ihtiyaç vardır.
FULL TEXT (PDF): 
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  • 1
27-33
  • Turkish

REFERENCES

References: 

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