p16 Improves interobserver agreement in diagnosis of anal intraepithelial neoplasia
| Autor: | Lea Novak, Isam A. Eltoum, Sarah M. Bean, R. S. Meara, Robin T. Vollmer, David C. Chhieng, Michael G. Conner, Stanley J. Robboy, D. Ralph Crowe |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Biopsy Diagnosis Differential Antigens Neoplasm Medicine Humans Aged Retrospective Studies Aged 80 and over Observer Variation business.industry Genes p16 Anal intraepithelial neoplasia food and beverages Obstetrics and Gynecology General Medicine DNA Neoplasm Middle Aged Anus Neoplasms Gene Expression Regulation Neoplastic Female Radiology Clinical Competence business Carcinoma in Situ |
| Zdroj: | Journal of lower genital tract disease. 13(3) |
| ISSN: | 1526-0976 |
| Popis: | Evaluation of anal intraepithelial neoplasia (AIN) is subjective. Previous studies have shown p16 and Ki-67 expressions to correlate with AIN grade. Biomarkers like p16 and Ki-67 may improve interobserver agreement. The objectives were (1) to determine the extent of interobserver agreement in evaluating AIN on routine hematoxylin and eosin (HE) sections and (2) to test whether p16 and/or Ki-67 staining improve interobserver diagnostic agreement.Seventy-seven anal specimens were retrieved. Sections were stained with monoclonal antibodies against p16 and Ki-67. Blind to the original diagnoses, 4 pathologists assessed HE alone, p16 alone, Ki-67 alone, and all 3 simultaneously. Diagnoses were normal/reactive, AIN I/HPV, AIN II, and AIN III. Agreement was calculated using kappa and S statistics.Pathologists were board certified and had 2 to 25 years (mean = 13.6 years) of experience. Fair agreement was observed using HE diagnosis alone (kappa = 0.38, S = 0.56). The p16 diagnostic evaluation demonstrated the highest agreement (kappa = 0.57, S = 0.73). Interobserver agreement for Ki-67 alone and for HE/p16/Ki-67 combined were comparable to that of HE alone (kappa = 0.4, S = 0.54 and kappa = 0.44, S = 0.62, respectively). When the pathologists' diagnoses for all diagnostic evaluations were compared with consensus diagnoses, the lowest average magnitude of disagreement was seen with Ki-67 alone, followed by p16 alone, HE/p16/Ki-67 combined, and HE alone.Interobserver agreement for diagnosis of AIN was fair when based solely on HE preparation. p16 alone improved interobserver agreement and demonstrated superior agreement when compared with HE, Ki-67, and HE/p16/Ki-67 combined. |
| Databáze: | OpenAIRE |
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