Interobserver variability in the diagnosis of uterine high-grade endometrioid carcinoma Journal Article
| Authors: | Thomas, S.; Hussein, Y.; Bandyopadhyay, S.; Cote, M.; Hassan, O.; Abdulfatah, E.; Alosh, B.; Guan, H.; Soslow, R. A.; Ali-Fehmi, R. |
| Article Title: | Interobserver variability in the diagnosis of uterine high-grade endometrioid carcinoma |
| Abstract: | Context. - Low interobserver diagnostic agreement exists among high-grade endometrial carcinomas. Objective. - To evaluate diagnostic variability in International Federation of Gynecology and Obstetrics (FIGO) grade 3 endometrioid adenocarcinoma (G3EC) in 2 different sign-out practices. Design. - Sixty-six G3EC cases were identified from pathology archives of Wayne State University (WSU, Detroit, Michigan) (general surgical pathology sign-out) and 65 from Memorial Sloan Kettering Cancer Center (MSK, New York, New York) (gynecologic pathology focused sign-out). Each case was reviewed together by 2 gynecologic pathologists, one from each institution, and classified into the G3EC group or a reclassified group. Clinicopathologic parameters were compared. Results. - Twenty-five WSU cases (38%) were reclassified as undifferentiated (n = 2), serous (n = 4), mixed endometrioid and serous carcinomas (n = 12), and FIGO grade 2 endometrioid adenocarcinomas with focal marked nuclear atypia (n = 7). Eleven MSK cases (17%) were reclassified as undifferentiated (n = 5), serous (n = 1), mixed endometrioid and serous carcinomas (n = 4), and mixed endometrioid and clear cell carcinomas (n = 1). Agreement rate between original and review diagnosis was 83% (54 of 65) at MSK and 62% (41 of 66) at WSU (P = .01) with an overall rate of 73% (95 of 131). There were more undifferentiated carcinomas at MSK than there were at WSU (45% [5 of 11] versus 8% [2 of 25]; P=.02). There were more grade 2 endometrioid adenocarcinomas with focal, marked nuclear atypia at WSU (28%; 7 of 25) than there were at MSK (0%) (P=.03). Mixed endometrioid and serous carcinoma was the most common misclassified subtype (44%; 16 of 36). Conclusion. - Moderate interobserver variability exists in the diagnosis of G3EC with a significantly greater diagnostic agreement rate in gynecologic pathology- focused sign-out than in general sign-out practice. |
| Journal Title: | Archives of Pathology & Laboratory Medicine |
| Volume: | 140 |
| Issue: | 8 |
| ISSN: | 0003-9985 |
| Publisher: | College of American Pathologists |
| Date Published: | 2016-08-01 |
| Start Page: | 836 |
| End Page: | 843 |
| Language: | English |
| DOI: | 10.5858/arpa.2015-0220-OA |
| PROVIDER: | scopus |
| PUBMED: | 27139150 |
| PMCID: | PMC5656271 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 September 2016 -- Source: Scopus |
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