Interobserver agreement in the diagnosis of pathologic findings in liver biopsy tissue of nonalcoholic fatty liver disease (NAFLD)

초록

Background: Histomorphologic criteria of pathologic findings observed in liver tissue of NAFLD patient is still subjective and it results in confusion to pathologists and clinicians. So we studied an interobserver agreement of pathologic findings of NAFLD and analysed causes of disagreement. Methods: 31 cases clinicopathologically diagnosed ans NAFLD from 10 hospitals were selected. At first, 1 H&E and 1 Masson-Trichrome stained virtual silide of each cases were blindly reviewed regarding 12 histological parameters by 13 pathologists belong to gastrointestinal study group of Korean Society of Pathologist. After 1st review, we analysed causes of disagreement and defined definite morphologic criteria. Second review with glass slides of each cases was performed after consensus meeting. The degree of interobserver agreement was determined by Kappa statistics. Results: Kappa values of 1st review were ranged from 0.0087 to 0.7617. Acidophilic bodies (kappa=0.7617) and portal inflammation (kappa=0.5913) showed high level of agreement. Microgranuloma (kappa=0.0984) and mirovesecular fatty change (kappa=0.0090) showed low level of agreement. The kappa value of four major pathologic findings such as steatosis grade, portal inflammation, ballooning degeneration, fibrosis were measured as 0.3829, 0.5913, 0.1923, 0.3303, respectively and, after second review, were increased to 0.5638, 0.7386, 0.3362, 0.4664, respectively. Conclusions: For correct diagnosis and interobserver agreement, it should be needed to define definite histomorphologic criteria of NAFLD.