ميزان همخواني تشخيصي دو پاتولوژيست در نتايج سيستم نمره دهي اصلاح شده نمايه فعاليت هپاتيت براي تعيين شدت و پيشرفت هپاتيت مزمن ويروسي

Interobserver variation of grading and staging scores in chronic hepatitis, based on modified Hepatitis Activity Index(HAI)

Better understanding of etiology and pathogenesis of chronic viral hepatitis and new methods for controlling or eradication of pathogenic viruses in recent years, mandates early diagnosis of the disease. An appropriate scoring system is also a necessity for grading the severity of necroinflammatory process and progress of disease. Reproducibility of a scoring system is a basic and important issue for selecting and using such a system. The purpose of this study is to estimate the degree of agreement and correlation between two pathologists using the modified Hepatitis Activity Index. One hundred and fifty series of liver needle biopsy slides obtained from the patients with viral hepatitis were reviewd in a double-blind order by two pathologists who were quite experienced in the interpretation of liver biopsy. Data was analysed by kappa wieghted value statistical method. Interface hepatitis showed the highest point of agreement whereas, this concurrence in grading severity of lesion was moderate. With respect to grading, the two observers had less than 2 scores difference in 63.3% of cases. Since the accuracy and clinical correlation of this system have already been proved by previous studies, this difference probably suggests lack of adequate and required agreement in using histologic criteria for HAI system by our patologists. Holding discussions and workshops will help pathologists to come to a better diagnostic accordance with this respect. In addition, further studies in order to suggest more effective and reproducible histologic criteria for the scoring systems would be necessary.