Histologic classification of tumor-infiltrating lymphocytes in primary cutaneous malignant melanoma: A study of interobserver agreement Journal Article


Authors: Busam, K. J.; Antonescu, C. R.; Marghoob, A. A.; Nehal, K. S.; Sachs, D. L.; Shia, J.; Berwick, M.
Article Title: Histologic classification of tumor-infiltrating lymphocytes in primary cutaneous malignant melanoma: A study of interobserver agreement
Abstract: The density and distribution of lymphocytes infiltrating the vertical growth phase of primary cutaneous melanomas has been suggested by several studies to be of prognostic significance. However, few pathologists comment on tumor-infiltrating lymphocytes (TILs), and there is the perception that the assessment of TILs is subject to great interobserver variability. We studied interobserver agreement on the categorization of TILs; 20 cases of primary cutaneous malignant melanoma with a vertical growth phase component were circulated among 3 pathologists and 3 dermatologists. For each case, TILs were classified as brisk, nonbrisk, or absent according to Clark. Only 1 pathologist (a dermatopathologist) was familiar with the classification of TILs. Observers were given written guidelines and a brief tutorial before their examination of the slides. Our results show that with little instruction, overall agreement among observers was good (kappa values, 0.6 or more), especially among pathologists (kappa values, > 0. 7). Three observers had excellent agreement among each other (kappa values, > 0. 75). These findings suggest that the categorization of TILs can be easily taught and can be applied with an acceptable level of reproducibility in routine diagnostic practice.
Keywords: disease classification; cancer staging; tumor associated leukocyte; lymphocytes, tumor-infiltrating; reproducibility; reproducibility of results; melanoma; cell growth; skin neoplasms; observer variation; histology; medical examination; statistical analysis; malignant melanoma; tumor-infiltrating lymphocytes; interobserver agreement; humans; prognosis; human; priority journal; article
Journal Title: American Journal of Clinical Pathology
Volume: 115
Issue: 6
ISSN: 0002-9173
Publisher: Oxford University Press  
Date Published: 2001-06-01
Start Page: 856
End Page: 860
Language: English
DOI: 10.1309/g6ek-y6eh-0lgy-6d6p
PUBMED: 11392882
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 21 May 2015 -- Source: Scopus
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MSK Authors
  1. Kishwer S Nehal
    278 Nehal
  2. Marianne Berwick
    120 Berwick
  3. Cristina R Antonescu
    895 Antonescu
  4. Ashfaq A Marghoob
    534 Marghoob
  5. Dana L Sachs
    23 Sachs
  6. Jinru Shia
    717 Shia
  7. Klaus J Busam
    688 Busam