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2014, Volume 30, Number 2, Page(s) 105-110     
[ Abstract (Turkish) ] [ PDF ] [ Similar Articles ]
DOI: 10.5146/tjpath.2014.01231
Interobserver Agreement Among Histological Patterns and Diagnosis in Lung Adenocarcinomas
Halide Nur ÜRER1, Rengin AHISKALI2, Naciye ARDA1, Sebnem BATUR3, Leyla CİNEL4, Gerhard DEKAN5, Neslihan FENER1, Pınar FIRAT6, Silvana GELEFF5, Büge ÖZ3, Yasemin ÖZLÜK6, Kürşat YILDIZ7, Emine Dilek YILMAZBAYHAN6, Handan ZEREN8, Atilla UYSAL9
1Departments of Pathology, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, ISTANBUL, TURKEY
2Department of Pathology, Marmara University, Faculty of Medicine, ISTANBUL, TURKEY
3Istanbul University, Cerrahpaşa Medicine Faculty, ISTANBUL, TURKEY
4Ministry of Health Istanbul Medeniyet University, ISTANBUL, TURKEY
5Medical University of Vienna, VIENNA, AUSTRIA
6Istanbul University, Istanbul Medicine Faculty, ISTANBUL, TURKEY
7Kocaeli University, Faculty of Medicine, ISTANBUL, TURKEY
8Acibadem University, Faculty of Medicine, ISTANBUL, TURKEY
9Departments of Chest Diseases, Yedikule Chest Diseases and Chest Surgery Education and Research Hospital, ISTANBUL, TURKEY
Keywords: Adenocarcinoma, Lung neoplasms, Interobserver variations

Objective: The aim of this study was to investigate the interobserver agreement in determination of the dominant histological pattern and the final diagnosis in lung adenocarcinomas.

Material and Method: A total of 12 patients with a diagnosis of primary lung adenocarcinoma were included in the study. Twelve pathologists from eight study centers were asked first to determine the dominant histological pattern in these cases and then to decide whether the final diagnosis was in situ, minimally invasive or invasive adenocarcinoma.

Results: The kappa value for the agreement in determining the dominant pattern among the pathologists was 0.36 (p<0.001), with the values for the lepidic, acinar, papillary, solid, micropapillary patterns and mucinous character of adenocarcinoma being 0.34, 0.28, 0.30, 0.80, 0.16 and 0.38 respectively (p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001). None of the cases was diagnosed as in situ adenocarcinoma. On the other hand, the kappa value for the agreement in differentiating minimally invasive from invasive adenocarcinoma among reviewers was 0.17 (p<0.001).

Conclusion: The agreement among pathologists in determining the subtype of lung adenocarcinomas that depends on the identification of the dominant pattern was at intermediate level. In addition, the agreement in deciding whether the case is minimally invasive or invasive, was at low level. The criteria defining the histological patterns should be clarified and described in more detail. Educational activities and larger multicenter studies might be helpful in improving the agreement and standardization.


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