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NJBMS - Volume 7, Issue 2, October - December 2016

Pages: 113-121
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Inter Observer Agreement In Fuhrman Nuclear Grading Of Renal Cell Carcinoma By Using Two Methods With And Without Micrometry

Author: Ashida M Krishnan, Sauda V M, Meera Arun

Category: Pathology


BACKGROUND: Among the many grading systems used in Renal cell carcinoma, the most widely accepted one is Fuhrman grading system, which is based on the nuclear size, outlines, and presence of nucleoli. This system has limited interobserver and intraobserver reproducibility due to many factors. Micrometer is a manually operated optical scale used for measuring cell dimensions in microscopy.

AIMS: To compare the interobserver agreement of Fuhrman nuclear grading of Renal cell carcinoma between two observers by using two methods -without using micrometry and with using micrometry.

SETTINGS AND DESIGN: Descriptive study on 49 cases of Nephrectomy samples with diagnosis of Renal cell carcinoma and its variants in a tertiary health care centre for a period of 2 years.

MATERIAL AND METHODS: After adequate fixation, sampling and meticulous screening of tumor sections; Renal cell carcinoma was first scored by Fuhrman grading system by the two observers and the interobserver agreement measured. Micrometry aided scoring done by the two observers again and the interobserver agreement between the two observers measured again.

STATISTICALANALYSIS USED: The results were analyzed by SPSS software.

RESULTS AND CONCLUSIONS: The interobserver kappa agreement without micrometry is 0.516. In the second method of grading with micrometry, the interoberver agreement was more (k=0.658). Interoberver reproducibility of Fuhrman grading is more, if done with more objective methods like micrometry.

Keywords: Fuhrman nuclear grading, Micrometry, Renal cell carcinoma