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Interobserver diagnostic reproducibility in advanced-stage endometrial carcinoma

Authors
Jung, Ho JinLee, Soo YeonHong, Jin HwaChun, Yi Kyeong
Issue Date
1월-2021
Publisher
KOREAN SOC PATHOLOGISTS
Keywords
Endometrial neoplasms; Uterine neoplasm; Observer variation
Citation
JOURNAL OF PATHOLOGY AND TRANSLATIONAL MEDICINE, v.55, no.1, pp.43 - 52
Indexed
SCOPUS
KCI
Journal Title
JOURNAL OF PATHOLOGY AND TRANSLATIONAL MEDICINE
Volume
55
Number
1
Start Page
43
End Page
52
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/50212
DOI
10.4132/jptm.2020.10.04
ISSN
2383-7837
Abstract
Background: The accurate pathologic diagnosis and subtyping of high-grade endometrial carcinoma are often problematic, due to its atypical and overlapping histopathological features. Methods: Three pathologists reviewed 21 surgically resected cases of advanced-stage endometrial carcinoma. The primary diagnosis was based only on hematoxylin and eosin stained slides. When a discrepancy arose, a secondary diagnosis was made by additional review of immunohistochemical (IHC) stains. Finally, three pathologists discussed all cases and rendered a consensus diagnosis. Results: The primary diagnoses were identical in 13/21 cases (62%). The secondary diagnosis based on the addition of IHC results was concordant in four of eight discrepant cases. Among four cases with discrepancies occurring in this step, two cases subsequently reached a consensus diagnosis after a thorough discussion between three reviewers. Next-generation sequencing (NGS) study was performed in two cases in which it was difficult to distinguish between serous carcinoma and endometrioid carcinoma. Based on the sequencing results, a final diagnosis of serous carcinoma was rendered. The overall kappa for concordance between the original and consensus diagnosis was 0.566 (moderate agreement). Conclusions: We investigated step-wise changes in interobserver diagnostic reproducibility in advanced-stage endometrial carcinoma. We demonstrated the utility of IHC and NGS study results in the histopathological diagnosis of advanced-stage endometrial carcinoma.
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