medigraphic.com
Instituto Nacional de Salud Pública

2010, Number 5

<< Back Next >>

salud publica mex 2010; 52 (5)

Reproducibility of histopathologic diagnosis of precursor lesions of gastric carcinoma in three Latin American countries.

Kasamatsu E, Bravo LE, Bravo JC, Aguirre-García J, Flores-Luna L, Nunes-Velloso MC, Hernández-Suárez G

Language: Spanish
References: 20
Page: 386-390
PDF size: 114.45 Kb.


ABSTRACT

Objective. The aim was to evaluate the concordance in the diagnosis of precursor lesions of intestinal-type gastric carcinoma among observers with different levels of experience. Material and Methods. Gastric biopsies from 1 056 cases were studied: 341 from Colombia, 382 from Mexico, and 333 from Paraguay. Pathologists without experience (A) and with experience (B) in gastrointestinal pathology, as well as experts working in an international reference center (C) participated in the diagnosis of each case. Results. The concordance (k) between pathologists with experience and those without was poor for the diagnosis of atrophic gastritis (k=0.04 to 0.12) and dysplasia (k=0.11 to 0.05), and good for the diagnosis of intestinal metaplasia (k=0.52 to 0.58). Supervision of pathologists without experience by those with experience remarkably improved the concordance in the diagnosis of atrophic gastritis (k=0.65) and intestinal metaplasia (k=0.91), and to a lesser degree, of dysplasia (k=0.28). The concordance among experts before and after the consensus meeting showed no variation in the diagnosis of atrophic gastritis (k=0.57); the concordance varied from good to excellent in the diagnosis of intestinal metaplasia (k=0.67 to 0.81) and from poor to good in that of dysplasia (k=0.18 to 0.66). Conclusion. The greatest differences arose in the diagnosis of chronic atrophic gastritis and dysplasia. The interobserver concordance depended on the experience of the observer and the consensus reading.


REFERENCES

  1. Parkin DM, Bray F, Ferlay J, Pisan P. Global cancer statistics, 2002. CA Cancer J Clin 2005;55:74-108.

  2. IARC Monograph on the Evaluation of Carcinogenics Risks to Human. Vol. 61. Schistosomes, liver flukes and Helicobacter pylori. Lyon International Agency for Research on Cancer, l994.

  3. Correa P, Cuello C, Duque E, Burbano LC, García FT, Bolaños O, et al. Gastric cancer in Colombia III: Natural history of precursor lesions. J Natl Cancer Inst 1976;57:1027-1035.

  4. You WC, Zhang L, Gail MH, Li JY, Chang YS, Blot WJ, et al. Precancerous lesions in two counties of China with contrasting cancer risk. Int J Epidemiol 1998;27:945-948.

  5. Naylor GM, Gotoda T, Dixon M, Shimoda T, Gatta L, Owen R, et al. Why does Japan have a high incidence of gastric cancer? Comparison of gastritis between UK and Japanese patients. Gut 2006;55:1545-1552.

  6. Correa P. Helicobacter pylori and gastric carcinogenesis. Am J Surg Pathol 1995;19(suppl 1):S37-S43.

  7. Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney System. Am J Surg Pathol 1996;20:1161-1181.

  8. Aydin O, Egilmez R, Karabacak T, Kanik A. Interobserver variation in histopathological assessment of Helicobacter pylori gastritis. World J Gastroenterol 2003;9:2232-2235.

  9. Guarner J, Herrera-Goepfert R, Mohar A, Sánchez L, Halperin D, Ley C, et al. Interobserver variability in application of revised Sydney classification for gastritis. Hum Pathol 1999;30:1431-1434.

  10. Andrew A, Wyatt JI, Dixon MF. Observer variation in the assessment of chronic gastritis according to the Sydney System. Histopathology 1994;25:17-22.

  11. El-Zimaity HMT, Graham DY, Al-Assi MT, Malaty H, Karttunen TJ, Graham DP, et al. Interobserver variation in the histopathological assessment of Helicobacter pylori gastritis. Hum Pathol 1996;27:35-41.

  12. Chen XY, van der Hulst RW, Bruno MJ, van der Ende A, Xiao SD, Tygat GN, et al. Interobserver variation in the histopathological scoring of Helicobacter pylori related gastritis. J Clin Pathol 1999;52:612-615.

  13. Bravo LE, Bravo JC, Realpe JL, Zarama G, Piazuelo MB, Correa P. Fuentes de variabilidad en el diagnóstico de gastritis atrófica multifocal asociada con la infección por Helicobacter pylori. Colomb Med 2008;56:58-65.

  14. Jass JR, Filipe MI. The mucin profiles of normal gastric mucosa, intestinal metaplasia and its variants and gastric carcinoma. Histochem J 1981;13:931-939.

  15. Rugge M, Correa P, Dixon MF, Fiocca R, Hattori T, Lechago J, et al. Gastric mucosal atrophy: interobserver consistency using new criteria for classificaction and grading. Aliment Pharmacol Ther 2002;16:1249-1259.

  16. Rugge M, Correa P, Dixon MF, Hattori T, Leandro G, Lewin K, et al. Gastric dysplasia. The Padova International Classificaction. Am J Surg Pathol 2000;24:167-176.

  17. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-174.

  18. Montgomery E, Bronner MP, Goldblum JR, Greenson JK, Haber MM, Hart J, et al. Reproducibility of the diagnosis of dysplasia in Barrett’s esophagus (BE). A reaffirmation. Hum Pathol 2001;32:368-378.

  19. Rousselet M-C, Michalak S, Dupré F, Croué A, Bedossa P, Saint-André J-P, et al. Sources of variability in histological scoring of chronic viral hepatitis. Hepatology 2005;41:257-264.

  20. Kaye PV, Haider SA, Ilyas M, James PD, Soomoro I, Faisal W, et al. Barrett’s dysplasia and the Vienna classification: reproducibility, prediction of progression and impact of consensus reporting and p53 immunohistochemistry. Histopathology 2009;54:699-712.




2020     |     www.medigraphic.com