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Acuerdo interobservador entre patólogos en el diagnóstico histopatológico y la clasificación de los pólipos

Elham Jafari¹, Mahdiye Lashkarizadeh², Nazanin Zeinali Nezhad³

¹Pathology and Stem Cell Research Center, Department of Pathology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.

Diagnostic pathology

|February 10, 2026

Resumen

El acuerdo del patólogo sobre el diagnóstico de pólipos colorrectales es bueno en general, pero varía significativamente para ciertos tipos como pólipos hiperplásticos e inflamatorios. Se necesita una mejor estandarización y capacitación para una clasificación precisa de la displasia y la evaluación de la lesión dentada.

Área de la Ciencia:

Gastroenterología y Gastroenterología.
Patología Patología Patología.
Oncología Oncología Oncología.

Sus antecedentes:

El diagnóstico histopatológico preciso de los pólipos colorrectales es crucial para el manejo del paciente y la prevención del cáncer.
La variabilidad entre observadores en la clasificación de pólipos puede afectar las decisiones de tratamiento y los resultados de los pacientes.

Objetivo del estudio:

Evaluar la consistencia entre los patólogos en el diagnóstico y clasificación de los pólipos colorrectales.
Identificar tipos específicos de pólipos y categorías de clasificación con un desacuerdo significativo entre los observadores.

Principales métodos:

Un estudio transversal que involucró a 253 especímenes de pólipos colorrectales evaluados por tres patólogos experimentados.
Los pólipos se clasificaron en seis tipos, y la displasia se clasificó.
El acuerdo entre observadores se cuantificó utilizando el coeficiente kappa ponderado de Cohen.

Principales resultados:

El acuerdo general para el diagnóstico histopatológico fue bueno (κ = 0,66).
Se observó un alto acuerdo para el carcinoma in situ (κ=0,87) y los pólipos adenomatosos (κ=0,78).
El acuerdo fue pobre para los pólipos inflamatorios (κ=0,16) y las úlceras rectales solitarias (κ=0,12), y justo para la clasificación de la displasia (κ=0,32).

Conclusiones:

Si bien el acuerdo es fuerte para los pólipos adenomatosos y el carcinoma, existe una variabilidad significativa para otros tipos de pólipos y la clasificación de la displasia.
Se recomiendan criterios de diagnóstico estandarizados y capacitación específica para mejorar la consistencia en la evaluación de pólipos colorrectales.
Se debe prestar especial atención a mejorar el acuerdo sobre las lesiones serradas y la clasificación de la displasia.

Palabras clave:

El adenoma es un adenoma.Cáncer Cáncer Cáncer Cáncer Colon Colon Colon es el nombre que se le da a una parte del colon.La displasia es una displasia.El pólipo es un pólipo.

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