Akihiko Yoshizawa1, Kenzo Hiroshima2,3,4, Akemi Takenaka5, Reiji Haba6, Kunimitsu Kawahara7, Yuko Minami8, Hirokuni Kakinuma9, Yasuo Shibuki10, Shinji Miyake11, Kenta Kajio7, Kana Kiyonaga6, Moe Nagatomo12, Sanako Nishimura13, Masayuki Mano5, Jun Matsubayashi14, Noriko Motoi15, Toshitaka Nagao14, Shin-Ichi Nakatsuka13, Tsutomu Yoshida16, Yukitoshi Satoh17. 1. Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan. 2. Department of Pathology, Tokyo Women's Medical University Yachiyo Medical Center, Yachiyo, Japan. 3. Department of Biochemistry and Genetics, Chiba University Graduate School of Medicine, Chiba, Japan. 4. Sodegaura Satsukidai Hospital, Sodegaura, Japan. 5. Department of Central Laboratory and Surgical Pathology, National Hospital Organization Osaka National Hospital, Osaka, Japan. 6. Department of Diagnostic Pathology, Kagawa University Hospital, Kagawa, Japan. 7. Department of Pathology, Osaka Habikino Medical Center, Osaka, Japan. 8. Department of Diagnostic Pathology, National Hospital Organization Ibarakihigashi National Hospital, the Center of Chest Diseases and Severe Motor & Intellectual Disabilities, Ibaraki, Japan. 9. Department of Pathology, Kumamoto University Hospital, Kumamoto, Japan. 10. Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan. 11. Department of Diagnostic Pathology, Tokyo Medical University Hospital, Tokyo, Japan. 12. Department of Central Laboratory, Osaka Toneyama Medical Center, Osaka, Japan. 13. Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan. 14. Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan. 15. Department of Pathology, Saitama Cancer Center, Saitama, Japan. 16. Department of Pathology, Kitasato University School of Medicine, Sagamihara, Japan. 17. Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Abstract
INTRODUCTION: The Japan Lung Cancer Society (JLCS) and the Japanese Society of Clinical Cytology (JSCC) have proposed a new four-tiered cytology reporting system for lung carcinoma (JLCS-JSCC system). Prior to the proposal, the Papanicolaou Society of Cytopathology (PSC) had proposed a revised reporting system (PSC system), which comprises the "neoplastic, benign neoplasm, and low-grade carcinoma" category (N-B-LG category), in addition to the 4 categories of the JLCS-JSCC system. This study aimed to evaluate the interobserver agreement of the JLCS-JSCC system with an additional dataset with more benign lesions in comparison with the PSC system. METHODS: We analyzed 167 cytological samples, which included 17 benign lesions, obtained from the respiratory system. Seven observers classified these cases into each category by reviewing one Papanicolaou-stained slide per case according to the JLCS-JSCC system and PSC system. RESULTS: The interobserver agreement was moderate in the JLCS-JSCC (k = 0.499) and PSC (k = 0.485) systems. Of the 167 samples, 17 samples were benign lesions: 7 pulmonary hamartomas, 5 sclerosing pneumocytomas, 2 squamous papillomas, one solitary fibrous tumor, one meningioma, and one lymphocytic proliferation. There were diverse sample types as follows: 11 touch smears, 3 brushing smears, 2 aspirations, and one sputum sample. Fourteen samples (82.3%) were categorized into "negative" or "atypical" by more than half of the observers in the JLCS-JSCC system. Conversely, 3 samples were categorized as "suspicious" or "malignant" by more than half of the observers in the JLCS-JSCC system. On the other hand, 11 samples (64.7%) were categorized into the N-B-LG category by more than half of the observers in the PSC system. CONCLUSIONS: The concordance rate in the JLCS-JSCC system was slightly higher than that in the PSC system; however, the interobserver agreement was moderate in both the JLCS-JSCC and PSC systems. These results indicate that both the JLCS-JSCC and PSC systems are clinically useful. Therefore, both systems are expected to have clinical applications. It may be important to integrate the 2 systems and construct a universal system that can be used more widely in clinical practice.
INTRODUCTION: The Japan Lung Cancer Society (JLCS) and the Japanese Society of Clinical Cytology (JSCC) have proposed a new four-tiered cytology reporting system for lung carcinoma (JLCS-JSCC system). Prior to the proposal, the Papanicolaou Society of Cytopathology (PSC) had proposed a revised reporting system (PSC system), which comprises the "neoplastic, benign neoplasm, and low-grade carcinoma" category (N-B-LG category), in addition to the 4 categories of the JLCS-JSCC system. This study aimed to evaluate the interobserver agreement of the JLCS-JSCC system with an additional dataset with more benign lesions in comparison with the PSC system. METHODS: We analyzed 167 cytological samples, which included 17 benign lesions, obtained from the respiratory system. Seven observers classified these cases into each category by reviewing one Papanicolaou-stained slide per case according to the JLCS-JSCC system and PSC system. RESULTS: The interobserver agreement was moderate in the JLCS-JSCC (k = 0.499) and PSC (k = 0.485) systems. Of the 167 samples, 17 samples were benign lesions: 7 pulmonary hamartomas, 5 sclerosing pneumocytomas, 2 squamous papillomas, one solitary fibrous tumor, one meningioma, and one lymphocytic proliferation. There were diverse sample types as follows: 11 touch smears, 3 brushing smears, 2 aspirations, and one sputum sample. Fourteen samples (82.3%) were categorized into "negative" or "atypical" by more than half of the observers in the JLCS-JSCC system. Conversely, 3 samples were categorized as "suspicious" or "malignant" by more than half of the observers in the JLCS-JSCC system. On the other hand, 11 samples (64.7%) were categorized into the N-B-LG category by more than half of the observers in the PSC system. CONCLUSIONS: The concordance rate in the JLCS-JSCC system was slightly higher than that in the PSC system; however, the interobserver agreement was moderate in both the JLCS-JSCC and PSC systems. These results indicate that both the JLCS-JSCC and PSC systems are clinically useful. Therefore, both systems are expected to have clinical applications. It may be important to integrate the 2 systems and construct a universal system that can be used more widely in clinical practice.
Authors: Paula S Ginter; Romana Idress; Timothy M D'Alfonso; Susan Fineberg; Shabnam Jaffer; Abida K Sattar; Anees Chagpar; Parker Wilson; Malini Harigopal Journal: Mod Pathol Date: 2020-10-19 Impact factor: 7.842