Interobserver reproducibility of perineural invasion of prostatic adenocarcinoma in needle biopsies.

Numerous studies have shown a correlation between perineural invasion (PNI) in prostate biopsies and outcome. The reporting of PNI varies widely in the literature. While the interobserver variability of prostate cancer grading has been studied extensively, less is known regarding the reproducibility...

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Published in:Virchows Archiv: European Journal of Pathology Vol. 478; no. 6; pp. 1109 - 1117
Main Authors: Egevad, Lars, Delahunt, Brett, Samaratunga, Hemamali, Tsuzuki, Toyonori, Olsson, Henrik, Ström, Peter, Lindskog, Cecilia, Häkkinen, Tomi, Kartasalo, Kimmo, Eklund, Martin, Ruusuvuori, Pekka
Format: pictorial research tables/charts Journal Article
Published: Springer Nature Jun2021
Online Access:View this record in EBSCOhost
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        atl: Interobserver reproducibility of perineural invasion of prostatic adenocarcinoma in needle biopsies.
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        au:
          Egevad, Lars
          Delahunt, Brett
          Samaratunga, Hemamali
          Tsuzuki, Toyonori
          Olsson, Henrik
          Ström, Peter
          Lindskog, Cecilia
          Häkkinen, Tomi
          Kartasalo, Kimmo
          Eklund, Martin
          Ruusuvuori, Pekka
        affil: Department of Oncology and Pathology, Karolinska Institutet, Karolinska University Hospital, Radiumhemmet P1:02, 171 76, Stockholm, Sweden
      sug:
        subj:
          Prostatic Neoplasms Pathology
          Prostate Pathology
          Neoplasm Invasiveness Pathology
          Adenocarcinoma Pathology
          Male
          Middle Age
          Aged
          Reproducibility of Results
          Immunohistochemistry Methods
          Biopsy
          Observer Bias
          Funding Source
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
      ab: Numerous studies have shown a correlation between perineural invasion (PNI) in prostate biopsies and outcome. The reporting of PNI varies widely in the literature. While the interobserver variability of prostate cancer grading has been studied extensively, less is known regarding the reproducibility of PNI. A total of 212 biopsy cores from a population-based screening trial were included in this study (106 with and 106 without PNI according to the original pathology reports). The glass slides were scanned and circulated among four pathologists with a special interest in urological pathology for assessment of PNI. Discordant cases were stained by immunohistochemistry for S-100 protein. PNI was diagnosed by all four observers in 34.0% of cases, while 41.5% were considered to be negative for PNI. In 24.5% of cases, there was a disagreement between the observers. The kappa for interobserver variability was 0.67-0.75 (mean 0.73). The observations from one participant were compared with data from the original reports, and a kappa for intraobserver variability of 0.87 was achieved. Based on immunohistochemical findings among discordant cases, 88.6% had PNI while 11.4% did not. The most common diagnostic pitfall was the presence of bundles of stroma or smooth muscle. It was noted in a few cases that collagenous micronodules could be mistaken for a nerve. The distance between cancer and nerve was another cause of disagreement. Although the results suggest that the reproducibility of PNI may be greater than that of prostate cancer grading, there is still a need for improvement and standardization.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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