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Inter-observer variability of cribriform architecture and percent Gleason pattern 4 in prostate cancer: relation to clinical outcome.
Virchows Archiv ( IF 3.5 ) Pub Date : 2020-08-20 , DOI: 10.1007/s00428-020-02902-9
Margaretha A van der Slot 1, 2 , Eva Hollemans 3 , Michael A den Bakker 1, 2 , Robert Hoedemaeker 4 , Mike Kliffen 1, 2 , Leo M Budel 1, 2 , Natascha N T Goemaere 1, 2 , Geert J L H van Leenders 3
Affiliation  

The Grade group is an important parameter for clinical decision-making in prostate cancer. Recently, percent Gleason pattern 4 and presence of invasive cribriform and/or intraductal carcinoma (CR/IDC) have been recognized for their independent predictive value for prostate cancer outcome. There is sparse data on the inter-observer agreement for these pathologic features in practice. Our objectives were to investigate inter-observer variability of percent Gleason pattern and CR/IDC and to relate individual tumour scores to clinical outcome. Our cohort included 80 consecutive radical prostatectomies with a median follow-up 87.1 months (interquartile range 43.3–119.2), of which the slide with largest tumour volume was scored by six pathologists for Grade group (four tiers: 1, 2, 3 and 4/5), percent Gleason pattern 4 (four tiers: 0–25%, 26–50%, 51–75% and 76–100%) and presence of CR/IDC (two tiers: absent, present). The individual assignments were related to post-operative biochemical recurrence (20/80). Inter-observer agreement was substantial (Krippendorff’s α 0.626) for assessment of Grade group and moderate for CR/IDC (α 0.507) and percent Gleason pattern 4 (α 0.551). For each individual pathologist, biochemical recurrence rates incremented by Grade group and presence of CR/IDC, although such relation was less clear for percent Gleason pattern 4. In conclusion, inter-observer agreement for CR/IDC and percent Gleason pattern 4 is lower than for Grade groups, indicating awareness of these features needs further improvement. Grade group and CR/IDC, but not percent Gleason pattern 4 was related to biochemical recurrence for each pathologist, indicating overall validity of individual grade assignments despite inter-observer variability.



中文翻译:

筛状结构的观察者间变异性和前列腺癌中格里森模式 4 的百分比:与临床结果的关系。

等级组是前列腺癌临床决策的重要参数。最近,格里森模式 4 的百分比和浸润性筛状癌和/或导管内癌 (CR/IDC) 的存在已被认可为它们对前列腺癌结果的独立预测价值。在实践中,关于这些病理特征的观察者间一致性的数据很少。我们的目标是调查格里森模式百分比和 CR/IDC 的观察者间变异性,并将个体肿瘤评分与临床结果相关联。我们的队列包括 80 次连续根治性前列腺切除术,中位随访时间为 87.1 个月(四分位距为 43.3-119.2),其中肿瘤体积最大的载玻片由 6 位病理学家评分为等级组(四级:1、2、3 和 4 /5),格里森模式 4 百分比(四级:0–25%、26–50%、51–75% 和 76–100%)和存在 CR/IDC(两层:不存在、存在)。个人分配与术后生化复发有关 (20/80)。观察者间的协议是实质性的(Krippendorff 的α 0.626) 用于评估等级组,CR/IDC 中等 ( α 0.507) 和格里森模式 4 百分比 ( α 0.551)。对于每个病理学家,生化复发率随等级组和 CR/IDC 的存在而增加,尽管这种关系对于格里森模式 4 百分比不太清楚。总之,CR/IDC 和格里森模式 4 百分比的观察者间一致性低于对于成绩组,表明对这些功能的认识需要进一步提高。等级组和 CR/IDC,但不是格里森模式 4 百分比与每位病理学家的生化复发相关,表明尽管观察者间存在差异,但个体等级分配的总体有效性。

更新日期:2020-08-20
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