Validation of Interobserver Agreement in Lung Cancer Assessment: Hematoxylin-Eosin Diagnostic Reproducibility for Non-Small Cell Lung Cancer The 2004 World Health Organization Classification and Therapeutically Relevant Subsets

被引：50

作者：

Grilley-Olson, Juneko E. ^{[1
,2
]}

Hayes, D. Neil ^{[1
,2
]}

Moore, Dominic T. ^{[2
]}

Leslie, Kevin O. ^{[3
]}

Wilkerson, Matthew D. ^{[2
]}

Qaqish, Bahjat F. ^{[2
]}

Hayward, Michele C. ^{[2
]}

Cabanski, Christopher R. ^{[2
,4
]}

Yin, Xiaoying ^{[2
]}

Socinski, Mark A. ^{[5
]}

Stinchcombe, Thomas E. ^{[1
,2
]}

Thorne, Leigh B.

Allen, Timothy Craig ^{[6
]}

Banks, Peter M. ^{[7
]}

Beasley, Mary B. ^{[8
]}

Borczuk, Alain C. ^{[9
]}

Cagle, Philip T. ^{[10
]}

Christensen, Rebecca ^{[11
]}

Colby, Thomas V. ^{[3
]}

Deblois, Georgean G. ^{[12
]}

Elmberger, Goran ^{[13
]}

Graziano, Paolo ^{[14
]}

Hart, Craig F. ^{[15
]}

Jones, Kirk D. ^{[16
]}

Maia, Diane M. ^{[17
]}

Miller, C. Ryan ^{[2
]}

Nance, Keith V. ^{[18
]}

Travis, William D. ^{[19
]}

Funkhouser, William K. ^{[2
]}

机构：

[1] Univ N Carolina, Dept Med, Sch Med, Div Hematol Oncol, Chapel Hill, NC 27599 USA

[2] Univ N Carolina, Lineberger Comprehens Canc Ctr, Sch Med, Chapel Hill, NC 27599 USA

[3] Mayo Clin Arizona, Dept Pathol, Scottsdale, AZ USA

[4] Univ N Carolina, Dept Stat & Operat Res, Chapel Hill, NC 27599 USA

[5] Univ Pittsburgh, Med Ctr, Div Hematol Oncol, Pittsburgh, PA USA

[6] Univ Texas Hlth Sci Ctr, Dept Pathol, Tyler, TX USA

[7] Carolinas Med Ctr, Dept Pathol, Charlotte, NC 28203 USA

[8] Mt Sinai Med Ctr, Dept Pathol, New York, NY 10029 USA

[9] Columbia Univ, Dept Pathol, Med Ctr, New York, NY USA

[10] Methodist Hosp Syst, Dept Pathol, Houston, TX USA

[11] Norton Healthcare Syst, Dept Pathol, Louisville, KY USA

[12] Commonwealth Lab Consultants, Dept Pathol, Richmond, VA USA

[13] Karolinska Univ Hosp, Dept Pathol, Stockholm, Sweden

[14] C Forlanini Hosp, Dept Pathol, Rome, Italy

[15] York Pathol Associates, Rock Hill, SC USA

[16] Univ Calif San Francisco, Dept Pathol, San Francisco, CA 94140 USA

[17] Kingsley Lane Pathol Associates, Norfolk, VA USA

[18] Rex Healthcare, Dept Pathol, Raleigh, NC USA

[19] Mem Sloan Kettering Canc Ctr, Dept Pathol, New York, NY 10021 USA

来源：

ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE | 2013年 / 137卷 / 01期

关键词：

HISTOLOGICAL CLASSIFICATION; OBSERVER VARIABILITY; CARCINOMA; CARBOPLATIN; PACLITAXEL; BEVACIZUMAB; MUTATIONS; OSAKA;

D O I：

10.5858/arpa.2012-0033-OA

中图分类号：

R446 [实验室诊断]; R-33 [实验医学、医学实验];

学科分类号：

1001 ;

摘要：

Context.-Precise subtype diagnosis of non-small cell lung carcinoma is increasingly relevant, based on the availability of subtype-specific therapies, such as bevacizumab and pemetrexed, and based on the subtype-specific prevalence of activating epidermal growth factor receptor mutations. Objectives.-To establish a baseline measure of interobserver reproducibility for non-small cell lung carcinoma diagnoses with hematoxylin-eosin for the current 2004 World Health Organization classification, to estimate interobserver reproducibility for the therapeutically relevant squamous/nonsquamous subsets, and to examine characteristics that improve interobserver reproducibility. Design.-Primary, resected lung cancer specimens were converted to digital (virtual) slides. Based on a single hematoxylin-eosin virtual slide, pathologists were asked to assign a diagnosis using the 2004 World Health Organization classification. Kappa statistics were calculated for each pathologist-pair for each slide and were summarized by classification scheme, pulmonary pathology expertise, diagnostic confidence, and neoplastic grade. Results.-The 12 pulmonary pathology experts and the 12 community pathologists each independently diagnosed 48 to 96 single hematoxylin-eosin digital slides derived from 96 cases of non-small cell lung carcinoma resection. Overall agreement improved with simplification from the comprehensive 44 World Health Organization diagnoses (kappa = 0.25) to their 10 major header subtypes (kappa = 0.48) and improved again with simplification into the therapeutically relevant squamous/nonsquamous dichotomy (kappa = 0.55). Multivariate analysis showed that higher diagnostic agreement was associated with better differentiation, better slide quality, higher diagnostic confidence, similar years of pathology experience, and pulmonary pathology expertise. Conclusions.-These data define the baseline diagnostic agreement for hematoxylin-eosin diagnosis of non-small cell lung carcinoma, allowing future studies to test for improved diagnostic agreement with reflex ancillary tests. (Arch Pathol Lab Med. 2013;137:32-40; doi: 10.5858/arpa.2012-0033-OA)

引用

页码：32 / 40

页数：9

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