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Related Experiment Videos

Observer variation in histologic classification of thyroid cancer

E Saxén, K Franssila, O Bjarnason

    Acta Pathologica Et Microbiologica Scandinavica. Section A, Pathology
    |November 1, 1978
    PubMed
    Summary

    Pathologist agreement on thyroid cancer diagnoses varied, with papillary carcinoma showing the most consistency. This highlights the need for standardized reviews to ensure reliable comparative studies in thyroid cancer research.

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    Area of Science:

    • Pathology
    • Oncology
    • Cancer Research

    Background:

    • Accurate histologic classification of thyroid tumors is crucial for patient management and epidemiological studies.
    • The World Health Organization (WHO) classification provides a framework for thyroid tumor diagnosis.
    • Interobserver variability in histologic interpretation can impact diagnostic reproducibility.

    Purpose of the Study:

    • To assess interobserver variation among Nordic pathologists when reviewing thyroid cancer histologic slides.
    • To evaluate the reproducibility of the WHO classification of thyroid tumors.
    • To identify specific thyroid cancer subtypes with higher diagnostic disagreement.

    Main Methods:

    • Review of 696 thyroid cancer cases by 5 Nordic pathologists.

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  • Analysis of diagnostic agreement and disagreement across different tumor types.
  • Comparison of diagnoses against established WHO classification criteria.

    • Main Results:

    • Complete agreement among all observers was achieved in 58% of cases; at least three agreed in 82%.
    • Observer disagreement was lowest for papillary carcinoma (7%) and highest for follicular carcinoma (27%).
    • Anaplastic and medullary carcinomas showed disagreement rates of 18% and 23%, respectively. Common misclassifications involved papillary vs. follicular carcinoma and follicular carcinoma vs. benign lesions.

    Conclusions:

    • Significant interobserver variation exists in the histologic diagnosis of thyroid cancer, particularly for follicular carcinoma.
    • The reproducibility of the WHO classification for thyroid tumors is moderate, necessitating careful application.
    • Standardized review by a consistent pathologist or group is essential for reliable comparative studies in thyroid cancer research.