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Reproducibility for histologic parameters in peritoneal mesothelioma
Douglas J Hartman1, Alain Borczuk2, Sanja Dacic1
1Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213.
Human Pathology
|July 18, 2017
Summary
Pathologist agreement on malignant peritoneal epithelioid mesothelioma subtypes is poor. This variability impacts the reliability of histopathologic parameters used for prognosis in these rare cancers.
Area of Science:
- Oncology
- Pathology
- Cancer Research
Background:
- Histologic subtype is a prognostic factor in malignant pleural and peritoneal mesothelioma.
- Epithelial morphology generally indicates a better prognosis compared to other subtypes.
- Recent studies suggest prognostic differences among epithelial peritoneal mesothelioma subtypes.
Purpose of the Study:
- To assess interobserver variability among pathologists in classifying epithelial subtypes of malignant peritoneal mesothelioma.
- To evaluate the agreement on various histopathologic parameters crucial for mesothelioma diagnosis and prognosis.
Main Methods:
- Four pathologists independently reviewed 67 cases of malignant peritoneal epithelioid mesotheliomas.
- Cases were subclassified into epithelial subtypes (papillary, tubulopapillary, trabecular, micropapillary, solid/pleomorphic).
- Histopathologic parameters including invasion depth, nuclear grade, and mitotic rate were also evaluated.
Main Results:
- Interobserver agreement was highest for mitotic rate (κ=0.36) and primary epithelial subtype (κ=0.32).
- Moderate agreement was observed for the solid subtype pattern (κ=0.49).
- Overall, interobserver variability for most histopathologic parameters was found to be poor.
Conclusions:
- Significant interobserver variability exists in the subclassification of epithelial peritoneal mesothelioma.
- This variability may affect the consistent application of histopathologic parameters for prognostic assessment.
- Further standardization in diagnostic criteria is needed for reliable mesothelioma subtyping.
