Pathologist Experience and Concordance in the Diagnosis of Dysplasia in Long-standing Inflammatory Bowel Disease
| Autor: | Isabel Salas, Maria Pellise, Maria José Paules, Isabel Quintanilla, Anna Domingo, Gemma Molist, Mireya Jimeno, María Rodríguez Sánchez, Sabela Carballal, Clara Salas, Miriam Cuatrecasas, Xavier Sanjuan, Carmen Teresa Pitti González |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Consensus Colorectal cancer Colon Concordance Biopsy Inflammatory bowel disease Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine medicine Humans In patient Prospective Studies Intestinal Mucosa Observer Variation business.industry Endoscopic biopsy Colonoscopy medicine.disease Inflammatory Bowel Diseases digestive system diseases Pathologists Dysplasia 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery Radiology Anatomy business Colorectal Neoplasms Precancerous Conditions |
| Zdroj: | The American journal of surgical pathology. 44(7) |
| ISSN: | 1532-0979 |
| Popis: | Surveillance colonoscopies focused to detect dysplasia are recommended to prevent colorectal cancer in patients with long-standing colonic inflammatory bowel disease (IBD). To date, histologic diagnosis and gradation of IBD-related dysplasia has been challenged by a high variability among pathologists. We aimed to analyze the observer characteristics that are correlated with concordance deviations in this diagnosis. Eight pathologists evaluated a set of 125 endoscopic biopsy samples with a representative distribution of nondysplastic and dysplastic lesions from long-standing IBD patients. Two rounds of diagnosis were carried out during a period of 18 months. The κ test was applied to analyze concordance. Pathologists were grouped on the basis of their experience. A subanalysis was performed by eliminating the highly prevalent nondysplastic samples, as well as an analysis after observers' grouping. Overall interobserver agreement was good (κ=0.73), with an even higher pairwise value (κ=0.86) as well as the intraobserver agreement values (best κ=0.85). After eliminating the highly prevalent nondysplastic samples, the interobserver agreement was still moderate to good (best overall κ=0.50; best paired κ=0.72). Notable differences were seen between the pathologists with a high-volume and low-volume practice (best overall κ=0.61 and 0.41, respectively). The agreement in the diagnosis of dysplasia in IBD endoscopic biopsies may have been undervalued over time. This is the first study evaluating pathologists' diagnostic robustness in this field. The results suggest that examining a large volume of samples is the key factor to increase the consistency in the diagnosis and gradation of IBD-related dysplasia. |
| Databáze: | OpenAIRE |
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