Colorectal dysplasia in chronic inflammatory bowel disease: a contemporary consensus classification and interobserver study.
Autor: | Harpaz N; Department of Pathology, Molecular and Cell-Based Medicine and Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA. Electronic address: noam.harpaz@mountsinai.org., Goldblum JR; Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, 44195, USA. Electronic address: GOLDBLJ@ccf.org., Shepherd NA; Gloucestershire Cellular Pathology Laboratory, Gloucester, GL53 7AN, UK. Electronic address: neil.a.shepherd@nhs.net., Riddell RH; Department of Laboratory Medicine and Pathobiology, Mount Sinai Hospital, Toronto, M5G 1X5, Canada. Electronic address: Robert.Riddell@sinaihealth.ca., Rubio CA; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, 171 64, Sweden. Electronic address: Carlos.Rubio@ki.se., Vieth M; Institute of Pathology, Bayreuth Clinic, Bayreuth, 95445, Germany. Electronic address: vieth.lkpathol@uni-bayreuth.de., Wang HH; Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA. Electronic address: hwang@bidmc.harvard.edu., Odze RD; Department of Pathology and Laboratory Medicine, Tufts University School of Medicine, Boston, MA, 02111, USA. Electronic address: rodze@tuftsmedicalcenter.org. |
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Jazyk: | angličtina |
Zdroj: | Human pathology [Hum Pathol] 2023 Aug; Vol. 138, pp. 49-61. Date of Electronic Publication: 2023 May 27. |
DOI: | 10.1016/j.humpath.2023.05.008 |
Abstrakt: | The clinical management of patients with dysplasia in chronic inflammatory bowel disease (IBD) is currently guided by Riddell et al.'s grading system (negative, indefinite, low grade, high grade) from 1983 which was based primarily on nuclear cytoarchitectural characteristics. Although most dysplasia in IBD resembles sporadic adenomas morphologically, other distinctive potential cancer precursors in IBD have been described over time. Recognizing the need for a updated comprehensive classification for IBD-associated dysplasia, an international working group of pathologists with extensive clinical and research experience in IBD devised a new classification system and assessed its reproducibility by having each participant assess test cases selected randomly from a repository of electronic images of potential cancer precursor lesions. The new classification system now encompasses three broad categories and nine sub-categories: 1) intestinal dysplasia (tubular/villous adenoma-like, goblet cell deficient, crypt cell, traditional serrated adenoma-like, sessile serrated lesion-like and serrated NOS), 2) gastric dysplasia (tubular/villous and serrated), and 3) mixed intestinal-gastric dysplasia. In the interobserver analysis, 67% of the diagnoses were considered definitive and achieved substantial inter-rater agreement. The key distinctions between intestinal and gastric lesions and between serrated and non-serrated lesions achieved substantial and moderate inter-rater agreement overall, respectively, however, the distinctions among certain serrated sub-categories achieved only fair agreement. Based on the Riddell grading system, definite dysplasia accounted for 86% of the collective responses (75% low grade, 11% high grade). Based on these results, this new classification of dysplasia in IBD can provide a sound foundation for future clinical and basic IBD research. (Copyright © 2023 Elsevier Inc. All rights reserved.) |
Databáze: | MEDLINE |
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