Reproducibility of measurement of myometrial invasion in endometrial carcinoma

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• 作者：Louis J. M. van der Putten ; Koen van de Vijver ; Carla Bartosch…
• 关键词：Endometrial carcinoma ; Myometrial invasion ; Depth of invasion ; Tumor ; free distance ; Inter ; observer variability
• 刊名：Virchows Archiv
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：470
• 期：1
• 页码：63-68
• 全文大小：877KB
• 刊物类别：Medicine
• 刊物主题：Pathology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1432-2307
• 卷排序：470

文摘

Myometrial invasion (MI) as a percentage (%MI), categorized into <50 or ≥50 %, is an important predictor of prognosis in endometrial carcinoma. Recent studies suggest that tumor-free distance (TFD) to serosa and the absolute depth of invasion (DOI) might be stronger predictors of prognosis. Although reproducibility is important in clinical practice for patient prognostication and treatment, reproducibility of these methods for the measurement of MI is largely unknown. One or two slides from 50 patients with FIGO stage I endometrioid endometrial carcinoma were viewed by seven gynecological pathologists, who were requested to measure %MI, TFD, and DOI. We categorized %MI as <50 % (including no MI) or ≥50 %, TFD as ≤1.75 or >1.75 mm (including no MI), ≤7 or >7 mm (including no MI), and ≤10 or >10 mm (including no MI) and DOI as <4 mm (including no MI) or ≥4 mm. Light’s kappa for multi-rater agreement was calculated. The %MI, TFD, and DOI could be measured in 88, 83, and 79 % of cases, respectively. Kappa was 0.75 for %MI, 0.77, 0.73, and 0.69 respectively for TFD with cutoffs of 1.75, 7, and 10 mm, and 0.59 for DOI. Pathologists reach substantial agreement when measuring %MI and TFD and moderate agreement when measuring DOI. The %MI can be measured in more cases than TFD and DOI. This supports the use of %MI in daily clinical practice, but future studies should compare %MI and TFD more extensively, including inter-observer variability.