Validation of histopathological chronicity scores in native kidney biopsies using light microscopy and digital morphometry for predicting renal outcome

IF 1.5 4区医学 Q3 PATHOLOGY Annals of Diagnostic Pathology Pub Date : 2024-08-23 DOI:10.1016/j.anndiagpath.2024.152368

Nandhini Gangadaran , Debasis Gochhait , Dhanajayan Govindan , P.S. Priyamvada , Sriram Krishnamurthy , Srinivas Bheemanathi Hanuman , Rajesh Nachiappa Ganesh

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Abstract

Quantitative assessment of chronicity changes in native kidney biopsies offer valuable insights in to disease prognosis, despite the strength of qualitative information. Yet, standardization and reproducibility remain challenging. The present study aims to assess and compare the prognostic utility and reproducibility of two chronicity scoring systems based on light microscopy and whole slide imaging with morphometry and also to evaluate the prognostic utility of structural measurements: cortical non-sclerotic glomerular (NSG) density and NSG area/volume. We designed a retrospective longitudinal study involving 101 adult and paediatric patients who underwent native kidney biopsies. Chronicity scoring was performed using two semi-quantitative methods: Method 1 (method proposed in PMID: 28314581) and Method 2 (method proposed in PMID: 32516862), under light microscopy as well as on whole-slide scanned images, and assessed for prognostic utility. Kidney-Failure-Risk-Equation (KFRE) was employed in combination with chronicity-scoring-methods and assessed for predictive capability. Interobserver reproducibility for the two chronicity methods was studied among three renal pathologists. Structural measurements were performed on whole-slide- scanned-images. Both the chronicity scoring methods significantly predicted decline in estimated glomerular filtration rate (eGFR) and persistent need for renal replacement therapy in follow-up. Method 1 combined with KFRE, outperformed Method 2 in predicting renal survival. Method 2 however showed higher interobserver reproducibility. Combined KFRE plus histopathological scoring methods showed better predictive accuracy. The study validates the precision of chronicity scoring using whole slide scanned images. The morphometric structural measurements showed significant correlations with follow-up eGFR, thereby providing supplementary prognostic information.

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使用光学显微镜和数字形态测量法验证原生肾活检组织病理慢性化评分，以预测肾脏预后

尽管定性信息很重要，但定量评估原生肾活检组织中的慢性变化可为疾病预后提供有价值的信息。然而，标准化和可重复性仍然具有挑战性。本研究旨在评估和比较基于光学显微镜和全切片成像与形态测量的两种慢性化评分系统的预后效用和可重复性，同时评估结构测量的预后效用：皮质非硬化性肾小球（NSG）密度和 NSG 面积/体积。我们设计了一项回顾性纵向研究，涉及 101 名接受原生肾活检的成人和儿童患者。慢性病评分采用两种半定量方法：方法 1（PMID: 28314581 中提出的方法）和方法 2（PMID: 32516862 中提出的方法），在光学显微镜下和全切片扫描图像上进行，并评估其预后效用。肾衰竭风险方程（KFRE）与慢性病评分方法结合使用，并对其预测能力进行了评估。三位肾脏病理学家对两种慢性化方法的观察者间可重复性进行了研究。结构测量是在全切片扫描图像上进行的。两种慢性化评分方法都能显著预测估计肾小球滤过率（eGFR）的下降和随访中对肾脏替代疗法的持续需求。方法 1 结合 KFRE 在预测肾脏存活率方面优于方法 2。不过，方法 2 在观察者之间的再现性更高。结合 KFRE 和组织病理学评分的方法显示出更好的预测准确性。该研究验证了使用整张切片扫描图像进行慢性化评分的精确性。形态结构测量结果与随访的 eGFR 有显著相关性，从而提供了辅助预后信息。

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来源期刊

Annals of Diagnostic Pathology 医学-病理学

CiteScore

3.90

自引率

5.00%

发文量

149

审稿时长

26 days

期刊介绍： A peer-reviewed journal devoted to the publication of articles dealing with traditional morphologic studies using standard diagnostic techniques and stressing clinicopathological correlations and scientific observation of relevance to the daily practice of pathology. Special features include pathologic-radiologic correlations and pathologic-cytologic correlations.