Validation of an algorithm for the diagnosis of serous tubal intraepithelial carcinoma.

MedStar author(s):
Citation: International Journal of Gynecological Pathology. 31(3):243-53, 2012 May.PMID: 22498942Institution: MedStar Washington Hospital CenterDepartment: PathologyForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal Article | Research Support, U.S. Gov't, Non-P.H.S. | Validation StudiesSubject headings: *Algorithms | *Carcinoma in Situ/di [Diagnosis] | *Fallopian Tube Neoplasms/di [Diagnosis] | Carcinoma in Situ/me [Metabolism] | Carcinoma in Situ/pa [Pathology] | Fallopian Tube Neoplasms/me [Metabolism] | Fallopian Tube Neoplasms/pa [Pathology] | Female | Humans | Ki-67 Antigen/me [Metabolism] | Observer Variation | Reproducibility of Results | Tumor Suppressor Protein p53/me [Metabolism]Year: 2012Local holdings: Available online from MWHC library: 2000 - presentISSN:
  • 0277-1691
Name of journal: International journal of gynecological pathology : official journal of the International Society of Gynecological PathologistsAbstract: It has been reported that the diagnosis of serous tubal intraepithelial carcinoma (STIC) is not optimally reproducible on the basis of only histologic assessment. Recently, we reported that the use of a diagnostic algorithm that combines histologic features and coordinate immunohistochemical expression of p53 and Ki-67 substantially improves reproducibility of the diagnosis. The goal of the current study was to validate this algorithm by testing a group of 6 gynecologic pathologists who had not participated in the development of the algorithm (3 faculty and 3 fellows) but who were trained in its use by referring to a website designed for the purpose. They then reviewed a set of microscopic slides, which contained 41 mucosal lesions of the fallopian tube. Overall consensus (>=4 of 6 pathologists) for the 4 categories of STIC, serous tubal intraepithelial lesion (our atypical intermediate category), p53 signature, and normal/reactive was achieved in 76% of the lesions, with no consensus in 24%. Combining diagnoses into 2 categories (STIC versus non-STIC) resulted in an overall consensus of 93% and no consensus in 7%. The k value for STIC versus non-STIC among all 6 observers was also high at 0.67 and did not significantly differ, whether for faculty (k=0.66) or fellows (k=0.60). These findings confirm the reproducibility of this algorithm by a group of gynecologic pathologists who were trained on a website for that purpose. Accordingly, we recommend its use in research studies. Before applying it to routine clinical practice, the algorithm should be evaluated by general surgical pathologists in a community setting.All authors: Gross A, Gupta M, Kuhn E, Kurman RJ, Li RF, Maambo E, Ronnett BM, Seidman JD, Shaw PA, Shih IeM, Soslow RA, Vang R, Visvanathan K, Yemelyanova AFiscal year: FY2012Digital Object Identifier: Date added to catalog: 2013-09-17
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 22498942 Available 22498942

Available online from MWHC library: 2000 - present

It has been reported that the diagnosis of serous tubal intraepithelial carcinoma (STIC) is not optimally reproducible on the basis of only histologic assessment. Recently, we reported that the use of a diagnostic algorithm that combines histologic features and coordinate immunohistochemical expression of p53 and Ki-67 substantially improves reproducibility of the diagnosis. The goal of the current study was to validate this algorithm by testing a group of 6 gynecologic pathologists who had not participated in the development of the algorithm (3 faculty and 3 fellows) but who were trained in its use by referring to a website designed for the purpose. They then reviewed a set of microscopic slides, which contained 41 mucosal lesions of the fallopian tube. Overall consensus (>=4 of 6 pathologists) for the 4 categories of STIC, serous tubal intraepithelial lesion (our atypical intermediate category), p53 signature, and normal/reactive was achieved in 76% of the lesions, with no consensus in 24%. Combining diagnoses into 2 categories (STIC versus non-STIC) resulted in an overall consensus of 93% and no consensus in 7%. The k value for STIC versus non-STIC among all 6 observers was also high at 0.67 and did not significantly differ, whether for faculty (k=0.66) or fellows (k=0.60). These findings confirm the reproducibility of this algorithm by a group of gynecologic pathologists who were trained on a website for that purpose. Accordingly, we recommend its use in research studies. Before applying it to routine clinical practice, the algorithm should be evaluated by general surgical pathologists in a community setting.

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