Using frozen section to identify histological patterns in stage I lung adenocarcinoma of ≤3 cm: Accuracy and interobserver agreement Journal Article
| Authors: | Yeh, Y. C.; Nitadori, J. I.; Kadota, K.; Yoshizawa, A.; Rekhtman, N.; Moreira, A. L.; Sima, C. S.; Rusch, V. W.; Adusumilli, P. S.; Travis, W. D. |
| Article Title: | Using frozen section to identify histological patterns in stage I lung adenocarcinoma of ≤3 cm: Accuracy and interobserver agreement |
| Abstract: | Aims: The IASLC/ATS/ERS classification of lung adenocarcinoma provides a prognostically significant histological subclassification. The aim of this study was to investigate the accuracy, limitations and interobserver agreement of frozen sections for predicting histological subtype. Methods and results: Frozen section and permanent section slides from 361 resected stage I lung adenocarcinomas ≤3 cm in size were reviewed for predominant histological subtype and the presence or absence of lepidic, acinar, papillary, micropapillary and solid patterns. Fifty cases were additionally reviewed by three pathologists to determine interobserver agreement. To test the accuracy of frozen section in judging degree of invasion, five pathologists reviewed frozen section slides from 35 cases with a predominantly lepidic pattern. There was moderate agreement on predominant histological subtype between frozen sections and final diagnosis (κ = 0.565). Frozen sections had high specificity for micropapillary and solid patterns (94% and 96%, respectively), but sensitivity was low (37% and 69%, respectively). The interobserver agreement was satisfactory (κ > 0.6, except for the acinar pattern). Conclusions: Frozen section can provide information on the presence of aggressive histological patterns-micropapillary and solid-with high specificity but low sensitivity. It was difficult to predict the predominant pattern on the basis of frozen sections, mostly because of sampling issues. © 2015 John Wiley & Sons Ltd. |
| Keywords: | adult; human tissue; major clinical study; histopathology; cancer recurrence; cancer staging; retrospective study; lung adenocarcinoma; cancer size; cancer classification; frozen section; invasion; frozen sections; pathologist; log rank test; positron; micropapillary; solid; sampling error; limited resection; histological subtype; human; male; female; priority journal; article |
| Journal Title: | Histopathology |
| Volume: | 66 |
| Issue: | 7 |
| ISSN: | 0309-0167 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2015-06-01 |
| Start Page: | 922 |
| End Page: | 938 |
| Language: | English |
| DOI: | 10.1111/his.12468 |
| PROVIDER: | scopus |
| PUBMED: | 24889415 |
| PMCID: | PMC4536823 |
| DOI/URL: | |
| Notes: | Export Date: 3 June 2015 -- Source: Scopus |
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