Interobserver diagnostic reproducibility in advanced-stage endometrial carcinoma

• Published in: Journal of pathology and translational medicine Vol. 55; no. 1; pp. 43 - 52
• Main Authors: Jung, Ho Jin, Lee, Soo Yeon, Hong, Jin Hwa, Chun, Yi Kyeong
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Pathologists, Korean Society for Cytopathology 01.01.2021; The Korean Society of Pathologists and the Korean Society for Cytopathology; Korean Society of Pathologists & the Korean Society for Cytopathology; 대한병리학회
• Subjects: Automation; Cancer; Deoxyribonucleic acid; DNA; endometrial neoplasms; Gynecology; Medical research; Mutation; observer variation; Original; Pathology; Reproducibility; Tumors; uterine neoplasm; 병리학; United States > US; Endometrial neoplasms; Observer variation; Uterine neoplasm
• ISSN: 2383-7837; 2383-7845
• DOI: 10.4132/jptm.2020.10.04

The accurate pathologic diagnosis and subtyping of high-grade endometrial carcinoma are often problematic, due to its atypical and overlapping histopathological features. Three pathologists reviewed 21 surgically resected cases of advancedstage 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. 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). We investigated stepwise 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.