Reproducibility of fuhrman nuclear grading of renal cell carcinoma: A preliminary study

Background: The aim of this study was to evaluate intraobserver and interobserver reproducibility of Fuhrman nuclear grading of renal cell carcinoma. Methods: Pathology slides from 46 cases of renal cell carcinoma were rescored by 2 pathologists according to the Fuhrman system. Both intraobserver and interobserver reproducibility were assessed using kappa statistics. Results: The initial Fuhrman grade was grade 1 in 4 of the cases (8.7%), grade 2 in 30 (65.2%), grade 3 in 11 (23.9%), and grade 4 in 1 (2.2%). After reviewing the slides by the same pathologist, grades were reassigned as follows: grade 1 in 8 cases (17.4%), grade 2 in 23 (50%), grade 3 in 14 (30.4%), and grade 4 in 1 (2.2%). Intraobserver reproducibility of the Fuhrman system was substantial (k = 0.66). Fuhrman grading by the second pathologist was grade 1 in 11 cases (23.9%), grade 2 in 27 (58.7%), grade 3 in 7 (15.2%), and grade 4 in 1 (2.2%). Interobserver reproducibility of the Fuhrman system was moderate (k = 0.42). Conclusions: Despite substantial intraobserver reproducibility of Fuhrman grading, moderate interobserver reproducibility and low agreement for grade 3 should be a consideration

Expression of heat shock protein 70 and endothelial nitric oxide synthase in placental tissue of preeclamptic and intrauterine growth-restricted pregnancies

Ischemia, hypoxia, and elevated vascular resistance disturb placental functions by increasing oxidative stress. Heat shock protein 70 (HSP70) is an oxidative stress marker. Endothelial nitric oxide synthase (eNOS) is a nitric oxide enzyme with a key role in pathologic and physiologic angiogenesis and vasculogenesis. This study was performed to investigate the role of oxidative stress in the pathogenesis of preeclampsia and intrauterine growth-restricted (IUGR) pregnancies by comparing the levels of HSP70 and eNOS in placentas from women with these diseases and those with healthy pregnancies.HSP70 and eNOS were examined using the streptavidin-biotin-peroxidase complex technique on formalin-fixed, paraffin-embedded sections from 135 placental villous tissues obtained from normal pregnancies (n=45) and pregnancies complicated with preeclampsia (n=45) and IUGR (n=45). The intensity of labeling in placental tissues with antibodies to HSP70 and eNOS was scored between 0 and 3, using a semiquantitative scale.HSP70 and eNOS levels were increased in the syncytiotrophoblasts, cytotrophoblasts, and extravillous trophoblast cells of preeclamptic and IUGR placentas (P<0.001), compared with normal pregnancies. However, their levels were increased only in the villous endothelial cells of IUGR placentas (P<0.001).Oxidative stress is thought to play an important role in the pathogenesis of preeclampsia and IUGR pregnancies. © 2010 Elsevier GmbH