Interobserver reproducibility in pathologist interpretation of columnar-lined esophagus.
Confirmation of endoscopically suspected esophageal metaplasia (ESEM) requires histology, but confusion in the histological definition of columnar-lined esophagus (CLE) is a longstanding problem. The aim of this study is to evaluate interpathologist variability in the interpretation of CLE. Thirty p...
| Publicado en: | Virchows Archiv: European Journal of Pathology Vol. 468; no. 2; pp. 159 - 168 |
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| Autores principales: | , , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Springer Nature
Feb2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=113486882&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 113486882 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09456317 O1Z jtl: Virchows Archiv: European Journal of Pathology issn: 09456317 maglogo: N pubinfo: dt: Feb2016 vid: 468 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 113486882 113486882 NLM26563401 113486882 10.1007/s00428-015-1878-5 NLM26563401 113486882 ppf: 159 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Interobserver reproducibility in pathologist interpretation of columnar-lined esophagus. aug: au: Mastracci, Luca Piol, Nataniele Molinaro, Luca Pitto, Francesca Tinelli, Carmine Silvestri, Annalisa Fiocca, Roberto Grillo, Federica De Silvestri, Annalisa affil: Department of Biomedical Sciences and Human Oncology, University of Turin, Via Santena 7 10126 Turin Italy sug: subj: Barrett Esophagus Pathology Epithelium Pathology Esophagus Pathology Esophageal Neoplasms Pathology Reproducibility of Results Aged Biopsy Barrett Esophagus Diagnosis Adult Metaplasia Esophageal Neoplasms Diagnosis Middle Age Human Aged: 65+ years Adult: 19-44 years Middle Aged: 45-64 years ab: Confirmation of endoscopically suspected esophageal metaplasia (ESEM) requires histology, but confusion in the histological definition of columnar-lined esophagus (CLE) is a longstanding problem. The aim of this study is to evaluate interpathologist variability in the interpretation of CLE. Thirty pathologists were invited to review three ten-case sets of CLE biopsies. In the first set, the cases were provided with descriptive endoscopy only; in the second and the third sets, ESEM extent using Prague criteria was provided. Moreover, participants were required to refer to a diagnostic chart for evaluation of the third set. Agreement was statistically assessed using Randolph's free-marginal multirater kappa. While substantial agreement in recognizing columnar epithelium (K = 0.76) was recorded, the overall concordance in clinico-pathological diagnosis was low (K = 0.38). The overall concordance rate improved from the first (K = 0.27) to the second (K = 0.40) and third step (K = 0.46). Agreement was substantial when diagnosing Barrett's esophagus (BE) with intestinal metaplasia or inlet patch (K = 0.65 and K = 0.89), respectively, in the third step, while major problems in interpretation of CLE were observed when only cardia/cardia-oxyntic atrophic-type epithelium was present (K = 0.05-0.29). In conclusion, precise endoscopic description and the use of a diagnostic chart increased consistency in CLE interpretation of esophageal biopsies. Agreement was substantial for some diagnostic categories (BE with intestinal metaplasia and inlet patch) with a well-defined clinical profile. Interpretation of cases with cardia/cardia-oxyntic atrophic-type epithelium, with or without ESEM, was least consistent, which reflects lack of clarity of definition and results in variable management of this entity. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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