Gleason grade 4 prostate adenocarcinoma patterns: an interobserver agreement study among genitourinary pathologists

被引:83
作者
Kweldam, Charlotte F. [1 ]
Nieboer, Daan [2 ]
Algaba, Ferran [3 ]
Amin, Mahul B. [4 ]
Berney, Dan M. [5 ]
Billis, Athanase [6 ]
Bostwick, David G. [7 ]
Bubendorf, Lukas [8 ]
Cheng, Liang [9 ]
Comperat, Eva [10 ]
Delahunt, Brett [11 ]
Egevad, Lars [12 ]
Evans, Andrew J. [13 ]
Hansel, Donna E. [14 ]
Humphrey, Peter A. [15 ]
Kristiansen, Glen [16 ]
van der Kwast, Theodorus H. [13 ]
Magi-Galluzzi, Cristina [17 ]
Montironi, Rodolfo [18 ]
Netto, George J. [19 ]
Samaratunga, Hemamali [20 ,21 ]
Srigley, John R. [22 ,23 ]
Tan, Puay H. [24 ]
Varma, Murali [25 ]
Zhou, Ming [26 ]
van Leenders, Geert J. L. H. [1 ]
机构
[1] Erasmus MC, Dept Pathol, Wytemaweg 80, NL-3015 CN Rotterdam, Netherlands
[2] Erasmus MC, Dept Publ Hlth, Rotterdam, Netherlands
[3] Univ Autonoma Barcelona, Dept Pathol, Barcelona, Spain
[4] Cedars Sinai Med Ctr, Dept Pathol & Lab Med, Los Angeles, CA 90048 USA
[5] Royal London Hosp, Dept Cellular Pathol, London, England
[6] State Univ Campinas Unicamp, Sch Med Sci, Dept Anat Pathol, Campinas, SP, Brazil
[7] Bostwick Labs, Orlando, FL USA
[8] Univ Basel Hosp, Inst Pathol, Basel, Switzerland
[9] Indiana Univ Sch Med, Dept Pathol & Lab Med, Indianapolis, IN 46202 USA
[10] Hop La Pitie Salpetriere, Serv Anat & Cytol Pathol Pr Capron, Paris, France
[11] Univ Otago, Dept Pathol & Mol Med, Wellington Sch Med & Hlth Sci, Wellington, New Zealand
[12] Karolinska Univ Hosp, Dept Pathol & Oncol, Stockholm, Sweden
[13] Univ Toronto, Univ Hlth Network, Dept Pathol & Lab Med, Toronto, ON, Canada
[14] Univ Calif San Diego, Dept Pathol, La Jolla, CA 92093 USA
[15] Yale Univ, Sch Med, Dept Pathol, New Haven, CT 06510 USA
[16] Univ Bonn, Inst Pathol, Bonn, Germany
[17] Cleveland Clin, Robert J Tomsich Pathol & Lab Med Inst, Cleveland, OH 44106 USA
[18] Polytech Univ Marche Reg Ancona, Sect Pathol Anat, Dept Biomed Sci & Publ Hlth, Ancona, Italy
[19] Johns Hopkins Med Inst, Dept Pathol, Baltimore, MD 21205 USA
[20] Aquesta Pathol, Brisbane, Qld, Australia
[21] Univ Queensland, Brisbane, Qld, Australia
[22] Trillium Hlth Partners, Mississauga, ON, Canada
[23] McMaster Univ, Hamilton, ON, Canada
[24] Singapore Gen Hosp, Dept Pathol, Singapore, Singapore
[25] Cardiff Univ, Dept Med Genet Haematol & Pathol, Cardiff, S Glam, Wales
[26] NYU, Dept Pathol, Langone Med Ctr, 550 1St Ave, New York, NY 10016 USA
关键词
Gleason grading; interobserver variability; prostate cancer; ISUP CONSENSUS CONFERENCE; ACTIVE SURVEILLANCE; INTRAOBSERVER REPRODUCIBILITY; INTERNATIONAL-SOCIETY; CRIBRIFORM PATTERN; CANCER; SCORE; CARCINOMA; BIOPSIES;
D O I
10.1111/his.12976
中图分类号
Q2 [细胞生物学];
学科分类号
071009 ; 090102 ;
摘要
AimsTo assess the interobserver reproducibility of individual Gleason grade 4 growth patterns. Methods and resultsTwenty-three genitourinary pathologists participated in the evaluation of 60 selected high-magnification photographs. The selection included 10 cases of Gleason grade 3, 40 of Gleason grade 4 (10 per growth pattern), and 10 of Gleason grade 5. Participants were asked to select a single predominant Gleason grade per case (3, 4, or 5), and to indicate the predominant Gleason grade 4 growth pattern, if present. Consensus' was defined as at least 80% agreement, and favoured' as 60-80% agreement. Consensus on Gleason grading was reached in 47 of 60 (78%) cases, 35 of which were assigned to grade 4. In the 13 non-consensus cases, ill-formed (6/13, 46%) and fused (7/13, 54%) patterns were involved in the disagreement. Among the 20 cases where at least one pathologist assigned the ill-formed growth pattern, none (0%, 0/20) reached consensus. Consensus for fused, cribriform and glomeruloid glands was reached in 2%, 23% and 38% of cases, respectively. In nine of 35 (26%) consensus Gleason grade 4 cases, participants disagreed on the growth pattern. Six of these were characterized by large epithelial proliferations with delicate intervening fibrovascular cores, which were alternatively given the designation fused or cribriform growth pattern (complex fused'). ConclusionsConsensus on Gleason grade 4 growth pattern was predominantly reached on cribriform and glomeruloid patterns, but rarely on ill-formed and fused glands. The complex fused glands seem to constitute a borderline pattern of unknown prognostic significance on which a consensus could not be reached.
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页码:441 / 449
页数:9
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