Reproducibility of histological cell type in high-grade endometrial carcinoma

Subclassification of endometrial carcinoma according to histological type shows variable interobserver agreement. The aim of this study was to assess specifically the interobserver agreement of histological type in high-grade endometrial carcinomas, recorded by gynecological pathologists from five a...

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Bibliographic Details
Published in:Modern pathology 2013-12, Vol.26 (12), p.1594-1604
Main Authors: Han, Guangming, Sidhu, Davinder, Duggan, Máire A, Arseneau, Jocelyne, Cesari, Matthew, Clement, Philip B, Ewanowich, Carol A, Kalloger, Steve E, Köbel, Martin
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biomarkers, Tumor - analysis
Cancer
Carcinoma, Endometrioid - pathology
Cystadenocarcinoma, Serous - pathology
Endometrial Neoplasms - pathology
Female
Gynecology
Health sciences
Humans
Immunohistochemistry
Laboratories
Medicine
Middle Aged
Morphology
Neoplasm Grading
Observer Variation
Pathology
Reproducibility
Reproducibility of Results
Tissue Array Analysis
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Summary:Subclassification of endometrial carcinoma according to histological type shows variable interobserver agreement. The aim of this study was to assess specifically the interobserver agreement of histological type in high-grade endometrial carcinomas, recorded by gynecological pathologists from five academic centers across Canada. In a secondary aim, the agreement of consensus diagnosis with immunohistochemical marker combinations was assessed including six routine (TP53, CDKN2A (p16), ER, PGR, Ki67, and VIM) and six experimental immunohistochemical markers (PTEN, ARID1A, CTNNB1, IGF2BP3, HNF1B, and TFF3). The paired interobserver agreement ranged from κ 0.50 to 0.63 (median 0.58) and the intraobserver agreement from κ 0.49 to 0.67 (median 0.61). Consensus about histological type based on morphological assessment was reached in 72% of high-grade endometrial carcinomas. A seven-marker immunohistochemical panel differentiated FIGO grade 3 endometrioid from serous carcinoma with a 100% concordance rate compared with the consensus diagnosis. More practically, a three-marker panel including TP53, ER, and CDKN2A (p16) can aid in the differential diagnosis of FIGO grade 3 endometrioid from endometrial serous carcinoma. Our study demonstrates that the inter- and intraobserver reproducibility of histological type based on morphology alone are mostly moderate. Ancillary techniques such as immunohistochemical marker panels are likely needed to improve diagnostic reproducibility of histological types within high-grade endometrial carcinomas.
ISSN:0893-3952
1530-0285
DOI:10.1038/modpathol.2013.102