Improved diagnostic stratification of digitised Barrett's oesophagus biopsies by p53 immunohistochemical staining

Autor: Myrtle van der Wel, Jaap van der Laan, Clément J. Huysentruyt, Jacques J. Bergman, Gursah Kats-Ugurlu, Fiebo J.W. ten Kate, Mike Visser, Lodewijk A. A. Brosens, Sybren L. Meijer, G Ineke van Lijnschoten, Ariadne Ooms, Michael Doukas, Roos E. Pouw, C A Seldenrijk, Lucas C. Duits, H. Valk, Arend Karrenbeld, G. J. A. Offerhaus, Katharina Biermann, Freek Moll, Jan G.P. Tijssen
Přispěvatelé: CCA - Cancer Treatment and Quality of Life, Amsterdam Cardiovascular Sciences, Cardiology, Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, Pathology, ACS - Heart failure & arrhythmias
Jazyk: angličtina
Rok vydání: 2018
Předmět:
medicine.medical_specialty
Histology
Biopsy
p53 immunohistochemistry
LOW-GRADE DYSPLASIA
GUIDELINES
Pathology and Forensic Medicine
03 medical and health sciences
Barrett Esophagus
whole-slide imaging
0302 clinical medicine
Metaplasia
Image Interpretation
Computer-Assisted
medicine
Journal Article
MANAGEMENT
Humans
Stage (cooking)
INCREASED RISK
Observer Variation
medicine.diagnostic_test
business.industry
review panel
ADENOCARCINOMA
General Medicine
Gold standard (test)
medicine.disease
Immunohistochemistry
Barrett's oesophagus
NEOPLASTIC PROGRESSION
PROTEIN ACCUMULATION
Dysplasia
030220 oncology & carcinogenesis
AGREEMENT
low-grade dysplasia
Adenocarcinoma
030211 gastroenterology & hepatology
METAPLASIA
Radiology
interobserver agreement
OVEREXPRESSION
medicine.symptom
Tumor Suppressor Protein p53
business
Biomarkers
Zdroj: Histopathology, 72(6), 1015. Wiley-Blackwell
Histopathology, 1015-1023. Wiley
STARTPAGE=1015;ENDPAGE=1023;ISSN=0309-0167;TITLE=Histopathology
Histopathology, 72(6), 1015-1023. Wiley-Blackwell
Histopathology, 72(6), 1015-1023. Wiley-Blackwell Publishing Ltd
van der Wel, M J, Duits, L C, Pouw, R E, Seldenrijk, C A, Offerhaus, G J A, Visser, M, Ten Kate, F J, Biermann, K, Brosens, L A A, Doukas, M, Huysentruyt, C, Karrenbeld, A, Kats-Ugurlu, G, van der Laan, J S, van Lijnschoten, G I, Moll, F C P, Ooms, A H A G, van der Valk, H, Tijssen, J G, Bergman, J J & Meijer, S L 2018, ' Improved diagnostic stratification of digitised Barrett's oesophagus biopsies by p53 immunohistochemical staining ', Histopathology, vol. 72, no. 6, pp. 1015-1023 . https://doi.org/10.1111/his.13462
ISSN: 0309-0167
Popis: AIMS: Interobserver agreement for dysplasia in Barrett's oesophagus (BO) is low, and guidelines advise expert review of dysplastic cases. The aim of this study was to assess the added value of p53 immunohistochemistry (IHC) for the homogeneity within a group of dedicated gastrointestinal (GI) pathologists.METHODS AND RESULTS: Sixty-single haematoxylin and eosin (HE) slide referral BO cases [20 low-grade dysplasia (LGD); 20 high-grade dysplasia (HGD); and 20 non-dysplastic BO reference cases] were digitalised and independently assessed twice in random order by 10 dedicated GI pathologists. After a 'wash-out' period, cases were reassessed with the addition of a corresponding p53 IHC slide. Outcomes were: (i) proportion of 'indefinite for dysplasia' (IND) diagnoses; (ii) interobserver agreement; and (iii) diagnostic accuracy as compared with a consensus 'gold standard' diagnosis defined at an earlier stage by five core expert BO pathologists after their assessment of this case set. Addition of p53 IHC decreased the mean proportion of IND diagnoses from 10 of 60 to eight of 60 (P = 0.071). Mean interobserver agreement increased significantly from 0.45 to 0.57 (P = 0.0021). The mean diagnostic accuracy increased significantly from 72% to 82% (P = 0.0072) after p53 IHC addition.CONCLUSION: Addition of p53 IHC significantly improves the histological assessment of BO biopsies, even within a group of dedicated GI pathologists. It decreases the proportion of IND diagnoses, and increases interobserver agreement and diagnostic accuracy. This justifies the use of accessory p53 IHC within our upcoming national digital review panel for BO biopsy cases.
Databáze: OpenAIRE
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