tailieunhanh - Báo cáo khoa hoc:" Histopathological grading of pediatric ependymoma: reproducibility and clinical relevance in European trial cohorts"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Histopathological grading of pediatric ependymoma: reproducibility and clinical relevance in European trial cohorts | Ellison et al. Journal of Negative Results in BioMedicine 2011 10 7 http content 10 1 7 r M 1 JOURNAL OF NEGATIVE RESULTS IN BIOMEDICINE RESEARCH Open Access Histopathological grading of pediatric ependymoma reproducibility and clinical relevance in European trial cohorts David W Ellison 1 Mehmet Kocak2 Dominique Figarella-Branger3 Giangaspero Felice4 Godfraind Catherine5 Torsten Pietsch6 Didier Frappaz7 Maura Massimino8 Jacques Grill9 James M Boyett2 and Richard G Grundy10 Abstract Background Histopathological grading of ependymoma has been controversial with respect to its reproducibility and clinical significance. In a 3-phase study we reviewed the pathology of 229 intracranial ependymomas from European trial cohorts of infants 2 trials - SFOP CNS9204 and older children 2 trials - AIEOP CNS9904 to assess both diagnostic concordance among five neuropathologists and the prognostic utility of histopathological variables particularly tumor grading. Results In phase 1 using WHO criteria and without first discussing any issue related to grading ependymomas pathologists assessed and independently graded ependymomas from 3 of 4 trial cohorts. Diagnosis of grade II ependymoma was less frequent than grade III a difference that increased when one cohort CNS9204 was reassessed in phase 2 during which the pathologists discussed ependymoma grading jointly reviewed all CNS9204 tumors and defined a novel grading system based on the WHO classification. In phase 3 repeat independent review of two cohorts SFOP CNS9904 using the novel system was associated with a substantial increase in concordance on grading. Extent of tumor resection was significantly associated with progression-free survival PFS in SFOP and AIEOP but not in CNS9204 and CNS9904. Strength of consensus on grade was significantly associated with PFS in only one trial cohort AIEOP . Consensus on the scoring of individual histopathological features necrosis angiogenesis cell density and mitotic activity