Interobserver variability in the pathological assessment of malignant colorectal polyps
| Autor: | D Snover, Julio Garcia-Aguilar, David A. Rothenberger, K Komuta, K Batts, Jose Jessurun, Robert D. Madoff |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Colorectal cancer Rectum Colonic Polyps Gastroenterology Endoscopy Gastrointestinal Internal medicine medicine Humans Pathological Aged Aged 80 and over Observer Variation medicine.diagnostic_test business.industry Carcinoma in situ Pathology Report Middle Aged medicine.disease digestive system diseases Endoscopy medicine.anatomical_structure Resection margin T-stage Surgery Female business Colorectal Neoplasms |
| Zdroj: | The British journal of surgery. 91(11) |
| ISSN: | 0007-1323 |
| Popis: | Background Treatment of patients with malignant large bowel polyps is highly dependent on pathological evaluation. The aim of this study was to evaluate interobserver variability in the pathological assessment of endoscopically removed polyps. Methods The records of 88 patients with colorectal cancer who underwent endoscopic removal of malignant polyps were reviewed. Study investigators reviewed the initial pathology report; three experienced gastrointestinal pathologists reviewed all slides in a blinded fashion. Interobserver variability of pathological assessment of malignant polyps was analysed by κ statistics. Results Seventy-six (86 per cent) of the 88 patients had malignant polyps and 12 (14 per cent) had carcinoma in situ. Agreement between experienced pathologists was substantial with regard to T stage (κ = 0·725), resection margin status (κ = 0·668) and Haggitt's classification (κ = 0·682), but comparison of initial and experienced pathologists' assessment demonstrated only moderate agreement in these areas (κ = 0·516, κ = 0·555 and κ = 0·578 respectively). Agreement between even experienced pathologists was poor with respect to histological grade of differentiated adenocarcinomas (κ = 0·163) and angiolymphatic vessel invasion (κ = − 0·017). Conclusion Pathological assessment of malignant polyps varies between observers. Specialist pathologists appear to have a higher degree of consensus among themselves than with generalist pathologists with respect to T stage. The high interobserver variability with regard to histological grade of differentiated tumours is clinically irrelevant. However, variability in the assessment of angiolymphatic vessel invasion limits the value of this measurement for clinical decision making. |
| Databáze: | OpenAIRE |
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