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Published on: October 16, 2013
Interobserver variability in the pathological assessment of malignant colorectal polyps
K Komuta1, K Batts, J Jessurun
1Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. komuta@net.nagasaki-u.ac.jp
The British Journal of Surgery
|September 24, 2004
Summary
Pathological assessment of malignant polyps shows variability among pathologists. While experienced specialists agree on T stage, their assessment of angiolymphatic invasion is unreliable for clinical decisions.
Area of Science:
- Gastroenterology
- Pathology
- Oncology
Background:
- Accurate pathological evaluation is crucial for managing malignant large bowel polyps.
- Endoscopic removal is a common treatment modality for these polyps.
Purpose of the Study:
- To assess the interobserver variability in the pathological evaluation of endoscopically removed malignant polyps.
- To compare agreement levels between initial and experienced pathologists.
Main Methods:
- Retrospective review of 88 patients with colorectal cancer treated by endoscopic polyp removal.
- Blinded slide review by three experienced gastrointestinal pathologists.
- Analysis of interobserver variability using kappa statistics.
Main Results:
- Substantial agreement among experienced pathologists for T stage (kappa=0.725), resection margins (kappa=0.668), and Haggitt's classification (kappa=0.682).
- Moderate agreement between initial and experienced pathologists for these parameters.
- Poor agreement for histological grade (kappa=0.163) and angiolymphatic invasion (kappa=-0.017).
Conclusions:
- Pathological assessment of malignant polyps exhibits observer variability.
- Experienced pathologists show higher consensus among themselves than with generalists regarding T stage.
- Variability in assessing angiolymphatic invasion limits its clinical utility.
