BACKGROUND: There are numerous subtypes of basal cell carcinoma (BCC). Defining the histopathologic subtype is an essential element in patient management, but there is little known data regarding interobserver precision in subtyping BCC. METHODS: We studied interobserver variance between six board-certified dermatopathologists who subtyped 100 BCCs in a blinded fashion. We used kappa statistic to calculate the concordance in suggested subtype by different dermatopathologists. Provided diagnoses were then re-categorized into low-risk and high-risk phenotypes, and kappa statistic for concordance on high-risk BCC was determined. RESULTS: The overall κ statistic was 0.301, indicating fair agreement among the six observers. Superficial and fibroepithelial BCC had the highest individual kappa statistics. When subtypes were re-classified into a two-tier system of high-risk and low-risk phenotypes, there was substantial interobserver agreement on high-risk BCC with a κ statistic of 0.699. CONCLUSION: These results suggest only fair agreement among dermatopathologists on specific BCC subtypes, but substantial agreement on superficial, fibroepithelial and high-risk BCC growth patterns. A simplified classification system comprised of superficial, fibroepithelial, nodular and infiltrative subtypes would increase interobserver precision and facilitate clinical decision-making.
BACKGROUND: There are numerous subtypes of basal cell carcinoma (BCC). Defining the histopathologic subtype is an essential element in patient management, but there is little known data regarding interobserver precision in subtyping BCC. METHODS: We studied interobserver variance between six board-certified dermatopathologists who subtyped 100 BCCs in a blinded fashion. We used kappa statistic to calculate the concordance in suggested subtype by different dermatopathologists. Provided diagnoses were then re-categorized into low-risk and high-risk phenotypes, and kappa statistic for concordance on high-risk BCC was determined. RESULTS: The overall κ statistic was 0.301, indicating fair agreement among the six observers. Superficial and fibroepithelial BCC had the highest individual kappa statistics. When subtypes were re-classified into a two-tier system of high-risk and low-risk phenotypes, there was substantial interobserver agreement on high-risk BCC with a κ statistic of 0.699. CONCLUSION: These results suggest only fair agreement among dermatopathologists on specific BCC subtypes, but substantial agreement on superficial, fibroepithelial and high-risk BCC growth patterns. A simplified classification system comprised of superficial, fibroepithelial, nodular and infiltrative subtypes would increase interobserver precision and facilitate clinical decision-making.
Authors: Mohamed El-Khalawany; Hussein M M Hassab-El-Naby; Ahmed Mustafa Mousa; Ahmed Sameh; Mahmoud A Rageh; Rasha Mahmoud Genedy; Aya Magdy Hosny; Marwa A Aboelmagd; Soha Aboeldahab Journal: J Cancer Res Clin Oncol Date: 2022-07-23 Impact factor: 4.322
Authors: Magdalena Ciążyńska; Grażyna Kamińska-Winciorek; Dariusz Lange; Bogumił Lewandowski; Adam Reich; Martyna Sławińska; Marta Pabianek; Katarzyna Szczepaniak; Adam Hankiewicz; Małgorzata Ułańska; Jan Morawiec; Maria Błasińska-Morawiec; Zbigniew Morawiec; Janusz Piekarski; Dariusz Nejc; Robert Brodowski; Anna Zaryczańska; Michał Sobjanek; Roman J Nowicki; Witold Owczarek; Monika Słowińska; Katarzyna Wróbel; Andrzej Bieniek; Anna Woźniacka; Małgorzata Skibińska; Joanna Narbutt; Wojciech Niemczyk; Karol Ciążyński; Aleksandra Lesiak Journal: Sci Rep Date: 2021-02-22 Impact factor: 4.379