A multinational, Internet-based assessment of observer variability in the diagnosis of serrated colorectal polyps

被引:78
作者
Glatz, Katharina
Pritt, Bobbi
Glatz, Dieter
Hartmann, Arndt
O'Brien, Michael J.
Blaszyk, Hagen
机构
[1] Univ Vermont, Coll Med, Dept Pathol, Burlington, VT 05405 USA
[2] Univ Regensburg, D-8400 Regensburg, Germany
[3] Boston Univ, Sch Med, Boston, MA 02118 USA
[4] Univ Basel, Dept Pathol, Basel, Switzerland
[5] Univ Basel, Dept Comp Sci, Basel, Switzerland
关键词
serrated polyps; observer variability; colon; Internet; MICROSATELLITE-UNSTABLE ADENOCARCINOMAS; HYPERPLASTIC POLYPOSIS; MOLECULAR CHARACTERISTICS; KRAS MUTATIONS; ADENOMAS; BRAF; PATHWAYS; TELEPATHOLOGY; INSTABILITY; PHENOTYPE;
D O I
10.1309/NXDB6FMTE9X5CD6Y
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
This Internet-based quiz (http://kathrin.unibas.ch/ polyp/) tested the diagnostic variability of 168 pathologists in the diagnosis of 20 colorectal polyps on 3 representative images, including hyperplastic polyps (HPs), traditional serrated adenomas (TSAs), sessile serrated adenomas (SSAs), and tubulovillous adenomas (TVAs). Interobserver variability for each of the 20 lesions was significant and was most pronounced for SSAs. Correct answers were independent of the participant's experience with TVAs, HPs, and TSAs. Participants with gastrointestinal subspecialty training and those who had read a reference article on serrated polyps gave a significantly higher percentage of correct answers for SSAs. The nomenclature used for serrated polyps was generally inconsistent. Our results suggest significant shortcomings in the routine H&E diagnosis of serrated colorectal polyps. A diagnostically unifying concept for lesions of the serrated neoplasia pathway, standardization of nomenclature, training of pathologists, and possibly development of ancillary techniques are of paramount importance for accurate patient management.
引用
收藏
页码:938 / 945
页数:8
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