Intraobserver and interobserver variability in distinguishing between endocervical and endometrial adenocarcinoma on problematic cases of cervical curettings

Paulette Mhawech-Fauceglia, Francois Herrmann, Wiam Bshara, Shaozeng Zhang, Remedios Penetrante, Shashikant Lele, Kunle Odunsi, Kerry Rodabaugh

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

We conducted a prospective study where 4 pathologists examined patients' problematic cases of cervical curetting for adenocarcinoma to determine whether it is of endocervical or endometrial origin based on 3 parameters: age, morphology, and immunohistochemistry (IHC) panel. Our aims were to evaluate the intraobserver and interobserver variability and to compare the results using those parameters to the final hysterectomy specimens. The value of morphology, morphology+age, and the combined parameters (morphology+age+IHC) in predicting the correct origin of the tumor was evaluated. The intraobserver agreements ranged from fair to almost perfect for each of morphology, morphology+age, and the combined parameters. The interobserver agreements were fair in the first review and ranged from slight to fair in the second review. The agreements between the diagnosis based on morphology, morphology+age, and the combined parameters compared with the final diagnosis on the hysterectomy specimen were slight (κ=0.137), fair (κ=0.290), and moderate (κ=0.497), respectively. We concluded that (i) discriminating between endocervical and endometrial carcinoma is highly subject to intraobserver and interobserver variability. (ii) Surprisingly, this variability is not affected by pathologists' experience. (iii) An IHC panel adds a useful piece of information to predict the tumor origin. Lastly, even though the combination of morphology, age, and IHC is far from perfect in predicting the correct origin of the tumor, it is still the best available method.

Original languageEnglish (US)
Pages (from-to)431-436
Number of pages6
JournalInternational Journal of Gynecological Pathology
Volume27
Issue number3
DOIs
StatePublished - Jul 2008

Keywords

  • Endocervical adenocarcinoma
  • Endometrial adenocarcinoma
  • Intraobserver and interobserver variability

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Obstetrics and Gynecology

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