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Interobserver Variation among Pathologists and Refinement of Criteria in Distinguishing Separate Primary Tumors from Intrapulmonary Metastases in Lung
Royal Brompton & Harefield Natl Hlth Serv Fdn Tru, London, England.;Imperial Coll, Natl Heart & Lung Inst, London, England..
Univ Colorado, Anschutz Med Campus, Aurora, CO USA..
Royal Brompton & Harefield Natl Hlth Serv Fdn Tru, London, England.;Imperial Coll, Natl Heart & Lung Inst, London, England..
Sullivan Nicolaides Pathol, Taringa, Qld, Australia..
Vise andre og tillknytning
2018 (engelsk)Inngår i: Journal of Thoracic Oncology, ISSN 1556-0864, E-ISSN 1556-1380, Vol. 13, nr 2, s. 205-217Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Multiple tumor nodules are seen with increasing frequency in clinical practice. On the basis of the 2015 WHO classification of lung tumors, we assessed the reproducibility of the comprehensive histologic assessment to distinguish second primary lung cancers (SPLCs) from intrapulmonary metastases (IPMs), looking for the most distinctive histologic features. An international panel of lung pathologists reviewed a scanned sequential cohort of 126 tumors from 48 patients and recorded an agreed set of histologic features, including tumor typing and predominant pattern of adenocarcinoma, thereby opining whether the case was SPLC, IPM, or a combination thereof. Cohen kappa statistics of 0.60 on overall assessment of SPLC or IPM indicated a good agreement. Likewise, there was good agreement (kappa score 0.64, p < 0.0001) between WHO histologic pattern in individual cases and SPLC or IPM status, but the proportions diversified for histologic pattern and SPLC or IPM status (McNemar test, p < 0.0001). The strongest associations for distinguishing between SPLC and IPM were observed for nuclear pleomorphism, cell size, acinus formation, nucleolar size, mitotic rate, nuclear inclusions, intraalveolar clusters, and necrosis. Conversely, the associations for lymphocytosis, mucin content, lepidic growth, vascular invasion, macrophage response, clear cell change, acute inflammation keratinization, and emperipolesis did not reach significance with tumor extent. Comprehensive histologic assessment is recommended for distinguishing SPLC from IPM with good reproducibility among lung pathologists. In addition to main histologic type and predominant patterns of histologic subtypes, nuclear pleomorphism, cell size, acinus formation, nucleolar size, and mitotic rate strongly correlate with pathologic staging status.

sted, utgiver, år, opplag, sider
ELSEVIER SCIENCE INC , 2018. Vol. 13, nr 2, s. 205-217
Emneord [en]
Lung cancer, Pathology, Multiple tumors, Interobserver variation
HSV kategori
Forskningsprogram
Patologi
Identifikatorer
URN: urn:nbn:se:uu:diva-349848DOI: 10.1016/j.jtho.2017.10.019ISI: 000424963400007PubMedID: 29127023OAI: oai:DiVA.org:uu-349848DiVA, id: diva2:1203313
Forskningsfinansiär
AstraZenecaTilgjengelig fra: 2018-05-03 Laget: 2018-05-03 Sist oppdatert: 2019-03-29bibliografisk kontrollert

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