Histologic grading of urothelial papillary neoplasms: impact of combined grading (two-numbered grading system) on reproducibility.

Tuna B., YÖRÜKOĞLU K., Duzcan E., ŞEN S., NESE N., SARSIK KUMBARACI B., ...Daha Fazla

Virchows Archiv : an international journal of pathology, cilt.458, sa.6, ss.659-64, 2011 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 458 Sayı: 6
  • Basım Tarihi: 2011
  • Doi Numarası: 10.1007/s00428-011-1072-3
  • Dergi Adı: Virchows Archiv : an international journal of pathology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.659-64
  • Anahtar Kelimeler: Bladder neoplasms, Grading, Reproducibility, ORGANIZATION INTERNATIONAL SOCIETY, UROLOGIC-PATHOLOGY CLASSIFICATION, WHO/ISUP CLASSIFICATION, BLADDER, CARCINOMA, VARIABILITY, PROGRESSION, RECURRENCE, AGREEMENT, TUMORS
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

The clinical management of tumor patients is often strongly infuenced by the tumor grade. The presence of heterogeneity is well recognized in a variety of tumors. Overall grade is based on highest grade area identified within a tumor. Urothelial carcinoma often contains different histological grades within the same tumor. This study investigates the impact of a combined grading system on the reproducibility of papillary urothelial neoplasms. A set prepared for an earlier study consisting of ten cases of each category (papillary urothelial neoplasm of low malignant potential (PUNLMP), LGPUC, and HGPUC) was used. Agreement between pairs of pathologists was evaluated using kappa statistics for the combined scoring system. Interobserver agreement was fair to substantial as reflected by kappa values ranging from 0.24 to 0.74 (mean kappa = 0.43). The combined scores of 2 and 3 which included PUNLMP showed the lowest degree of agreement and when this category was excluded from the analysis, interobserver agreement increased significantly (mean kappa = 0.65; ranging from 0.43 to 0.92) in terms of combined scores of 4, 5, and 6. PUNLMP has been shown to be the least reproducible component of a combined scoring system even among experienced observers. Exclusion of PUNLMP from grading scheme seems to improve interobserver variability.