Interobserver diagnostic reproducibility in advanced-stage endometrial carcinoma

Area of Science:

• Oncology
• Pathology
• Genomics

Background:

• High-grade endometrial carcinoma presents diagnostic challenges due to overlapping histopathological features.
• Accurate subtyping is crucial for effective patient treatment strategies.

Purpose of the Study:

• To evaluate the impact of immunohistochemistry (IHC) and next-generation sequencing (NGS) on the diagnostic reproducibility of advanced-stage endometrial carcinoma.
• To assess interobserver agreement among pathologists in diagnosing challenging cases.

Main Methods:

• Three pathologists reviewed 21 surgically resected advanced-stage endometrial carcinoma cases.
• Initial diagnosis relied on hematoxylin and eosin (H&E) staining, followed by IHC for discrepancies.
• Next-generation sequencing (NGS) was utilized in ambiguous cases to confirm diagnosis.

Main Results:

• Initial diagnoses agreed in 62% of cases.
• IHC improved concordance in four of eight discrepant cases.
• NGS aided in distinguishing between serous and endometrioid carcinoma, leading to definitive diagnoses.

Conclusions:

• Stepwise integration of IHC and NGS enhances interobserver diagnostic reproducibility in advanced-stage endometrial carcinoma.
• These ancillary techniques are valuable tools for improving histopathological diagnosis in complex cases.