BACKGROUND: The classification of lung tumors by the World Health Organization (WHO 1981) describes subtyping of adenocarcinoma of the lung (ACL) into acinar adenocarcinoma and papillary adenocarcinoma, bronchioloalveolar carcinoma, and solid carcinoma with mucus formation. Acinar and papillary adenocarcinoma may be graded as well-, moderately, or poorly differentiated. This study evaluated the interobserver variability in the subtyping and grading of ACL according to the WHO classification. METHODS: Histologic specimens from 211 patients with disease of Stages IIIa-IV were classified in a blind manner by three panelists. All available paraffin-embedded tissue blocks, including metastatic tumors, were sampled, and new slides were made for the study. RESULTS: Twenty-two ACL tumors could not be assigned a subtype by Panelist 1, which left 189 tumors as the basis for additional evaluation. Overall agreement for the three panelists regarding subtypes was 41%. Nonchance agreement was evaluated by kappa statistics, which may vary between -1 in the event of agreement that is less than that expected by chance and /1 in the event of full agreement. The kappa value regarding subtypes was 0.18 (95% confidence limits, 0.14-0.23). Overall observed agreement regarding degree of differentiation was 43%, with a kappa value of 0.12 (95% confidence limits, 0.06-0.17). Histologic material was obtained by thoracotomy in a subgroup of 53 patients, and in this patient group unanimity among two or more panelists was 88% for subtyping and 100% for degree of differentiation. CONCLUSIONS: The degree of agreement in subtying and grading of ACL in Stages IIIa-IV is low, suggesting that more objective criteria is needed before a prognostic impact of such variables can be assessed. The quality and quantity of material available for subtyping obviously influence the results, which is reflected in a better agreement when histologic material is obtained by thoracotomy.
BACKGROUND: The classification of lung tumors by the World Health Organization (WHO 1981) describes subtyping of adenocarcinoma of the lung (ACL) into acinar adenocarcinoma and papillary adenocarcinoma, bronchioloalveolar carcinoma, and solid carcinoma with mucus formation. Acinar and papillary adenocarcinoma may be graded as well-, moderately, or poorly differentiated. This study evaluated the interobserver variability in the subtyping and grading of ACL according to the WHO classification. METHODS: Histologic specimens from 211 patients with disease of Stages IIIa-IV were classified in a blind manner by three panelists. All available paraffin-embedded tissue blocks, including metastatic tumors, were sampled, and new slides were made for the study. RESULTS: Twenty-two ACL tumors could not be assigned a subtype by Panelist 1, which left 189 tumors as the basis for additional evaluation. Overall agreement for the three panelists regarding subtypes was 41%. Nonchance agreement was evaluated by kappa statistics, which may vary between -1 in the event of agreement that is less than that expected by chance and /1 in the event of full agreement. The kappa value regarding subtypes was 0.18 (95% confidence limits, 0.14-0.23). Overall observed agreement regarding degree of differentiation was 43%, with a kappa value of 0.12 (95% confidence limits, 0.06-0.17). Histologic material was obtained by thoracotomy in a subgroup of 53 patients, and in this patient group unanimity among two or more panelists was 88% for subtyping and 100% for degree of differentiation. CONCLUSIONS: The degree of agreement in subtying and grading of ACL in Stages IIIa-IV is low, suggesting that more objective criteria is needed before a prognostic impact of such variables can be assessed. The quality and quantity of material available for subtyping obviously influence the results, which is reflected in a better agreement when histologic material is obtained by thoracotomy.
Authors: Luis F R Taveira; Tahsin Kurc; Alba C M A Melo; Jun Kong; Erich Bremer; Joel H Saltz; George Teodoro Journal: J Digit Imaging Date: 2019-06 Impact factor: 4.056
Authors: Erik Thunnissen; Mary Beth Beasley; Alain C Borczuk; Elisabeth Brambilla; Lucian R Chirieac; Sanja Dacic; Douglas Flieder; Adi Gazdar; Kim Geisinger; Philip Hasleton; Yuichi Ishikawa; Keith M Kerr; Sylvie Lantejoul; Yoshiro Matsuno; Yuko Minami; Andre L Moreira; Noriko Motoi; Andrew G Nicholson; Masayuki Noguchi; Daisuke Nonaka; Giuseppe Pelosi; Iver Petersen; Natasha Rekhtman; Victor Roggli; William D Travis; Ming S Tsao; Ignacio Wistuba; Haodong Xu; Yasushi Yatabe; Maureen Zakowski; Birgit Witte; Dirk Joop Kuik Journal: Mod Pathol Date: 2012-07-20 Impact factor: 7.842
Authors: Jens Neumann; Friedrich Feuerhake; Gian Kayser; Thorsten Wiech; Konrad Aumann; Bernward Passlick; Paul Fisch; Martin Werner; Axel Zur Hausen Journal: BMC Cancer Date: 2010-03-02 Impact factor: 4.430
Authors: Kristy A Warner; Erin L Crawford; Aiman Zaher; Robert J Coombs; Haitham Elsamaloty; Stacie L Roshong-Denk; Imran Sharief; Guillermo V Amurao; Yongsook Yoon; Amro Y Al-Astal; Ragheb A Assaly; Dawn-Alita R Hernandez; Timothy G Graves; Charles R Knight; Michael W Harr; Todd B Sheridan; Jeffrey P DeMuth; Robert J Zahorchak; Jeffrey R Hammersley; Dan E Olson; Samuel J Durham; James C Willey Journal: J Mol Diagn Date: 2003-08 Impact factor: 5.568
Authors: Juneko E Grilley-Olson; D Neil Hayes; Dominic T Moore; Kevin O Leslie; Matthew D Wilkerson; Bahjat F Qaqish; Michele C Hayward; Christopher R Cabanski; Xiaoying Yin; Mark A Socinski; Thomas E Stinchcombe; Leigh B Thorne; Timothy Craig Allen; Peter M Banks; Mary B Beasley; Alain C Borczuk; Philip T Cagle; Rebecca Christensen; Thomas V Colby; Georgean G Deblois; Göran Elmberger; Paolo Graziano; Craig F Hart; Kirk D Jones; Diane M Maia; C Ryan Miller; Keith V Nance; William D Travis; William K Funkhouser Journal: Arch Pathol Lab Med Date: 2012-05-14 Impact factor: 5.534