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Problems in the reproducibility of classification of small lung adenocarcinoma: an international interobserver study

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dc.contributor.authorBOZKURTLAR, EMİNE
dc.contributor.authorsShih A. R., Uruga H., BOZKURTLAR E., Chung J., Hariri L. P., Minami Y., Wang H., Yoshizawa A., Muzikansky A., Moreira A. L., et al.
dc.date.accessioned2023-04-05T08:02:42Z
dc.date.available2023-04-05T08:02:42Z
dc.date.issued2019-11-01
dc.description.abstractAims The 2015 WHO classification for lung adenocarcinoma (ACA) provides criteria for adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (INV), but differentiating these entities can be difficult. As our understanding of prognostic significance increases, inconsistent classification is problematic. This study assesses agreement within an international panel of lung pathologists and identifies factors contributing to inconsistent classification. Methods and results Sixty slides of small lung ACAs were reviewed digitally by six lung pathologists in three rounds, with consensus conferences and examination of elastic stains in round 3. The panel independently reviewed each case to assess final diagnosis, invasive component size and predominant pattern. The kappa value for AIS and MIA versus INV decreased from 0.44 (round 1) to 0.30 and 0.34 (rounds 2 and 3). Interobserver agreement for invasion (AIS versus other) decreased from 0.34 (round 1) to 0.29 and 0.29 (rounds 2 and 3). The range of the measured invasive component in a single case was up to 19.2 mm among observers. Agreement was excellent in tumours with high-grade cytology and fair with low-grade cytology. Conclusions Interobserver agreement in small lung ACAs was fair to moderate, and improved minimally with elastic stains. Poor agreement is primarily attributable to subjectivity in pattern recognition, but high-grade cytology increases agreement. More reliable methods to differentiate histological patterns may be necessary, including refinement of the definitions as well as recognition of other features (such as high-grade cytology) as a formal part of routine assessment.
dc.identifier.citationShih A. R., Uruga H., BOZKURTLAR E., Chung J., Hariri L. P., Minami Y., Wang H., Yoshizawa A., Muzikansky A., Moreira A. L., et al., "Problems in the reproducibility of classification of small lung adenocarcinoma: an international interobserver study", HISTOPATHOLOGY, cilt.75, sa.5, ss.649-659, 2019
dc.identifier.doi10.1111/his.13922
dc.identifier.endpage659
dc.identifier.issn0309-0167
dc.identifier.issue5
dc.identifier.startpage649
dc.identifier.urihttps://pubmed.ncbi.nlm.nih.gov/31107973/
dc.identifier.urihttps://hdl.handle.net/11424/288237
dc.identifier.volume75
dc.language.isoeng
dc.relation.ispartofHISTOPATHOLOGY
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectTıp
dc.subjectHistoloji-Embriyoloji
dc.subjectCerrahi Tıp Bilimleri
dc.subjectPatoloji
dc.subjectYaşam Bilimleri
dc.subjectMoleküler Biyoloji ve Genetik
dc.subjectSağlık Bilimleri
dc.subjectTemel Tıp Bilimleri
dc.subjectBiyokimya
dc.subjectTemel Bilimler
dc.subjectMedicine
dc.subjectHistology and Embryology
dc.subjectSurgery Medicine Sciences
dc.subjectPathology
dc.subjectLife Sciences
dc.subjectMolecular Biology and Genetics
dc.subjectHealth Sciences
dc.subjectFundamental Medical Sciences
dc.subjectBiochemistry
dc.subjectNatural Sciences
dc.subjectHÜCRE BİYOLOJİSİ
dc.subjectYaşam Bilimleri (LIFE)
dc.subjectPATOLOJİ
dc.subjectBiyoloji ve Biyokimya
dc.subjectCELL BIOLOGY
dc.subjectMOLECULAR BIOLOGY & GENETICS
dc.subjectLife Sciences (LIFE)
dc.subjectPATHOLOGY
dc.subjectBIOLOGY & BIOCHEMISTRY
dc.subjectPatoloji ve Adli Tıp
dc.subjectHistoloji
dc.subjectBiyokimya (tıbbi)
dc.subjectMoleküler Biyoloji
dc.subjectHücre Biyolojisi
dc.subjectPathology and Forensic Medicine
dc.subjectHistology
dc.subjectBiochemistry (medical)
dc.subjectMolecular Biology
dc.subjectCell Biology
dc.subjecthistological pattern
dc.subjectinterobserver agreement
dc.subjectlung adenocarcinoma
dc.subjectminimally invasive adenocarcinoma
dc.subjectIASLC/ATS/ERS CLASSIFICATION
dc.subjectPROGNOSTIC-SIGNIFICANCE
dc.subjectINDEPENDENT PREDICTOR
dc.subjectSTAGE
dc.subjectASSOCIATION
dc.subjectCANCER
dc.subjectRECURRENCE
dc.subjectSUBTYPE
dc.subjectMICROPAPILLARY
dc.subjectINVASION
dc.subjecthistological pattern
dc.subjectinterobserver agreement
dc.subjectlung adenocarcinoma
dc.subjectminimally invasive adenocarcinoma
dc.titleProblems in the reproducibility of classification of small lung adenocarcinoma: an international interobserver study
dc.typearticle
dspace.entity.typePublication
local.avesis.ide5ac841b-ba09-412b-b014-ffe79a0bcfc0
local.indexed.atWOS
local.indexed.atPUBMED
local.indexed.atSCOPUS
relation.isAuthorOfPublication2343a71e-12cf-42ea-89ed-b222d121f733
relation.isAuthorOfPublication.latestForDiscovery2343a71e-12cf-42ea-89ed-b222d121f733

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