Hippe, Katrin and Kreft, Andreas and Reu-Hofer, Simone and Rosenwald, Andreas and Ferrazzi, Fulvia and Daniel, Christoph and Amann, Kerstin and Kraus, Sabrina and Holler, Ernst and Kandulski, Arne and Hirsch, Daniela and Buttner, Anke and Roesler, Wolf and Hildner, Kai and Winkler, Julia and Buettner-Herold, Maike (2023) Round-Robin test for the histological diagnosis of acute colonic Graft-versus-Host disease validating established histological criteria and grading systems. VIRCHOWS ARCHIV, 483 (1). pp. 47-58. ISSN 0945-6317, 1432-2307
Full text not available from this repository.Abstract
Histomorpholgy is one of the mainstays of acute Graft-versus-host disease (GvHD) diagnosis. However, concerns about reproducibility and the most appropriate grading system question its usefulness. Our aim was to assess histomorphological parameters and previously reported grading systems for GvHD regarding reproducibility and validity. Moreover, we propose that sum scores, derived by combining separately scored morphological parameters into a total score, might provide a simplified but equally effective means to grade GvHD. A total of 123 colon biopsies were assessed across four pathologists for intestinal GvHD using a Round-Robin test and results were correlated with clinical findings. Interobserver reproducibility was high for histological parameters that were evaluated as indicators of acute GvHD. Published grading systems were moderately reproducible (ICC 0.679-0.769) while simplified sum scores, in comparison, showed better interrater reliability (ICC 0.818-0.896). All grading systems and sum scores were associated with clinical signs of GvHD and in part with therapy response and survival. However, they were not able to stratify patients according to the clinical severity of GvHD. In a hot-spot analysis 1 crypt apoptotic body (CAB) in 10 crypts was a reasonable cut-off value for minimal diagnostic criteria of GvHD. In conclusion, histology can contribute to the diagnosis of GvHD and is reproducible. Published grading systems are able to reflect clinical findings as are simplified sum scores, which showed improved reproducibility and might be easier to handle as they are based on adding up histological parameters rather than transferring histological findings into a separate grading system. Sum scores will have to be further tested in a prospective setting.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | GASTROINTESTINAL-TRACT; MYCOPHENOLATE; BIOPSIES; HISTOPATHOLOGY; FEATURES; SUFFICIENT; APOPTOSIS; Round-Robin test; Acute Graft-versus-host disease; Colon biopsy; Interobserver agreement; Grading |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) Medicine > Lehrstuhl für Pathologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 16 Mar 2024 14:47 |
| Last Modified: | 16 Mar 2024 14:47 |
| URI: | https://pred.uni-regensburg.de/id/eprint/60251 |
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