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The Oxford classification of IgA nephropathy: pathology definitions, correlations, and reproducibility
Roberts, Ian S. D.1; Cook, H. Terence2; Troyanov, Stephan3; Alpers, Charles E.4; Amore, Alessandro5; Barratt, Jonathan6; Berthoux, Francois7; Bonsib, Stephen8; Bruijn, Jan A.9; Cattran, Daniel C.10; Coppo, Rosanna5; D′ Agati, Vivette11; D′ Amico, Giuseppe12; Emancipator, Steven13; Emma, Francesco14; Feehally, John6; Ferrario, Franco15; Fervenza, Fernando C.16; Florquin, Sandrine17; Fogo, Agnes18; Geddes, Colin C.19; Groene, Hermann-Josef20; Haas, Mark21; Herzenberg, Andrew M.22,23; Hill, Prue A.24; Hogg, Ronald J.25; Hsu, Stephen I.26; Jennette, J. Charles27; Joh, Kensuke28; Julian, Bruce A.29; Kawamura, Tetsuya30; Lai, Fernand M.31; Li, Lei-Shi32; Li, Philip K. T.33; Liu, Zhi-Hong32; Mackinnon, Bruce19; Mezzano, Sergio34; Schena, F. Paolo35; Tomino, Yasuhiko36; Walker, Patrick D.38; Wang, Haiyan37; Weening, Jan J.39; Yoshikawa, Nori40; Zhang, Hong37; Int IgA Nephropathy Network; Renal Pathol Soc
关键词Glomerulonephritis Iga Nephropathy Oxford Classification Pathology Renal Failure
WOS标题词Science & Technology
类目[WOS]Urology & Nephrology
研究领域[WOS]Urology & Nephrology

Pathological classifications in current use for the assessment of glomerular disease have been typically opinion-based and built on the expert assumptions of renal pathologists about lesions historically thought to be relevant to prognosis. Here we develop a unique approach for the pathological classification of a glomerular disease, IgA nephropathy, in which renal pathologists first undertook extensive iterative work to define pathologic variables with acceptable inter-observer reproducibility. Where groups of such features closely correlated, variables were further selected on the basis of least susceptibility to sampling error and ease of scoring in routine practice. This process identified six pathologic variables that could then be used to interrogate prognostic significance independent of the clinical data in IgA nephropathy (described in the accompanying article). These variables were (1) mesangial cellularity score; percentage of glomeruli showing (2) segmental sclerosis, (3) endocapillary hypercellularity, or (4) cellular/fibrocellular crescents; (5) percentage of interstitial fibrosis/tubular atrophy; and finally (6) arteriosclerosis score. Results for interobserver reproducibility of individual pathological features are likely applicable to other glomerulonephritides, but it is not known if the correlations between variables depend on the specific type of glomerular pathobiology. Variables identified in this study withstood rigorous pathology review and statistical testing and we recommend that they become a necessary part of pathology reports for IgA nephropathy. Our methodology, translating a strong evidence-based dataset into a working format, is a model for developing classifications of other types of renal disease.

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作者单位1.Erasmus MC, Rotterdam, Netherlands
2.Wakayama Med Univ, Dept Pediat, Wakayama, Japan
3.Univ Hlth Network, Dept Pathol, Toronto, ON, Canada
4.Univ Toronto, Toronto, ON M5S 1A1, Canada
5.St Vincents Hosp, Melbourne, Vic, Australia
6.Scott & White Med Ctr, Temple, TX USA
7.E Natl Hosp, Clin Res Ctr Chiba, Div Immunopathol, Chiba, Japan
8.Jikei Univ, Sch Med, Div Nephrol & Hypertens, Tokyo, Japan
9.Policlin, Renal Dialysis & Transplant Unit, Bari, Italy
10.Nephropathol Associates, Little Rock, AR USA
11.John Radcliffe Hosp, Dept Cellular Pathol, Oxford OX3 9DU, England
12.Univ London Imperial Coll Sci Technol & Med, London, England
13.Univ Montreal, Hop Sacre Coeur Montreal, Montreal, PQ, Canada
14.Univ Washington, Med Ctr, Dept Pathol, Seattle, WA 98195 USA
15.Univ Turin, Nephrol Dialysis & Transplantat Unit, Regina Margherita Childrens Hosp, Turin, Italy
16.Leicester Gen Hosp, John Walls Renal Unit, Leicester LE5 4PW, Leics, England
17.CHU St Etienne, Hop Nord, Dept Nephrol Dialysis & Renal Transplantat, St Etienne, France
18.LSU Hlth Sci Ctr, Dept Pathol, Shreveport, LA USA
19.Leiden Univ, Dept Pathol, Med Ctr, Leiden, Netherlands
20.Toronto Gen Res Inst, Univ Hlth Network, Toronto, ON, Canada
21.Columbia Univ Coll Phys & Surg, Dept Pathol, New York, NY 10032 USA
22.Fdn DAmico Ric Malattie Renali, Milan, Italy
23.Case Western Reserve Univ, Dept Pathol, Cleveland, OH 44106 USA
24.Bambino Gesu Childrens Hosp & Res Inst, Dept Nephrol & Urol, Div Nephrol & Dialysis, Rome, Italy
25.San Carlo Borromeo Hosp, Renal Immunopathol Ctr, Milan, Italy
26.Mayo Clin, Div Nephrol & Hypertens, Rochester, MN USA
27.Vanderbilt Univ, Dept Pathol, Nashville, TN USA
28.Univ Amsterdam, Acad Med Ctr, Dept Pathol, NL-1105 AZ Amsterdam, Netherlands
29.Univ Glasgow, Western Infirm, Renal Unit, Glasgow G11 6NT, Lanark, Scotland
30.German Canc Res Ctr, Dept Cellular & Mol Pathol, D-6900 Heidelberg, Germany
31.Johns Hopkins Univ, Sch Med, Dept Pathol, Baltimore, MD 21205 USA
32.Univ Florida, Coll Med, Div Nephrol Hypertens & Renal Transplantat, Gainesville, FL USA
33.Univ N Carolina, Dept Pathol & Lab Med, Chapel Hill, NC USA
34.Univ Alabama, Dept Med, Birmingham, AL 35294 USA
35.Chinese Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China
36.Nanjing Univ, Res Inst Nephrol, Jinling Hosp, Sch Med, Nanjing 210008, Peoples R China
37.Chinese Univ Hong Kong, Prince Wales Hosp, Dept Med, Hong Kong, Hong Kong, Peoples R China
38.Univ Austral Chile, Escuela Med, Dept Nefrol, Valdivia, Chile
39.Juntendo Univ, Sch Med, Div Nephrol, Dept Internal Med, Tokyo 113, Japan
40.Peking Univ, Div Renal, Hosp 1, Inst Nephrol, Beijing 100871, Peoples R China
GB/T 7714
Roberts, Ian S. D.,Cook, H. Terence,Troyanov, Stephan,et al. The Oxford classification of IgA nephropathy: pathology definitions, correlations, and reproducibility[J]. KIDNEY INTERNATIONAL,2009,76(5):546-556.
APA Roberts, Ian S. D..,Cook, H. Terence.,Troyanov, Stephan.,Alpers, Charles E..,Amore, Alessandro.,...&Renal Pathol Soc.(2009).The Oxford classification of IgA nephropathy: pathology definitions, correlations, and reproducibility.KIDNEY INTERNATIONAL,76(5),546-556.
MLA Roberts, Ian S. D.,et al."The Oxford classification of IgA nephropathy: pathology definitions, correlations, and reproducibility".KIDNEY INTERNATIONAL 76.5(2009):546-556.
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