TY - JOUR
T1 - Intraobserver and interobserver variability in distinguishing between endocervical and endometrial adenocarcinoma on problematic cases of cervical curettings
AU - Mhawech-Fauceglia, Paulette
AU - Herrmann, Francois
AU - Bshara, Wiam
AU - Zhang, Shaozeng
AU - Penetrante, Remedios
AU - Lele, Shashikant
AU - Odunsi, Kunle
AU - Rodabaugh, Kerry
PY - 2008/7
Y1 - 2008/7
N2 - 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.
AB - 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.
KW - Endocervical adenocarcinoma
KW - Endometrial adenocarcinoma
KW - Intraobserver and interobserver variability
UR - http://www.scopus.com/inward/record.url?scp=50349088113&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=50349088113&partnerID=8YFLogxK
U2 - 10.1097/PGP.0b013e3181601792
DO - 10.1097/PGP.0b013e3181601792
M3 - Article
C2 - 18580323
AN - SCOPUS:50349088113
SN - 0277-1691
VL - 27
SP - 431
EP - 436
JO - International Journal of Gynecological Pathology
JF - International Journal of Gynecological Pathology
IS - 3
ER -