Histotype classification of ovarian carcinoma: A comparison of approaches

Major changes in the classification of ovarian carcinoma histotypes occurred over the last two decades, resulting in the current 2014 World Health Organization (WHO) diagnostic criteria that recognize five principal histotypes: high-grade serous, low-grade serous, endometrioid, clear cell, and mucin...

Full description

Saved in:
Bibliographic Details
Published in:Gynecologic oncology 2018-10, Vol.151 (1), p.53-60
Main Authors: Peres, Lauren C., Cushing-Haugen, Kara L., Anglesio, Michael, Wicklund, Kristine, Bentley, Rex, Berchuck, Andrew, Kelemen, Linda E., Nazeran, Tayyebeh M., Gilks, C. Blake, Harris, Holly R., Huntsman, David G., Schildkraut, Joellen M., Rossing, Mary Anne, Köbel, Martin, Doherty, Jennifer A.
Format: Article
Language:English
Subjects:
Adult
Aged
Biomarkers, Tumor - analysis
Carcinoma - classification
Carcinoma - diagnosis
Carcinoma - mortality
Carcinoma - pathology
Female
Histotype
Humans
Immunohistochemistry
Middle Aged
Neoplasm Grading
Ovarian carcinoma
Ovarian Neoplasms - classification
Ovarian Neoplasms - diagnosis
Ovarian Neoplasms - mortality
Ovarian Neoplasms - pathology
Ovary - pathology
Practice Guidelines as Topic
Stage
Survival
World Health Organization
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Major changes in the classification of ovarian carcinoma histotypes occurred over the last two decades, resulting in the current 2014 World Health Organization (WHO) diagnostic criteria that recognize five principal histotypes: high-grade serous, low-grade serous, endometrioid, clear cell, and mucinous carcinoma. We assessed the impact of these guidelines and use of immunohistochemical (IHC) markers on classification of ovarian carcinomas in existing population-based studies. We evaluated histotype classification for 2361 ovarian carcinomas diagnosed between 1999 and 2009 from two case-control studies using three approaches: 1. pre-2014 WHO (“historic”) histotype; 2. Standardized review of pathology slides using the 2014 WHO criteria alone; and 3. An integrated IHC assessment along with the 2014 WHO criteria. We used Kappa statistics to assess agreement between approaches, and Kaplan-Meier survival curves and Cox proportional hazards models to evaluate mortality. Compared to the standardized pathologic review histotype, agreement across approaches was high (kappa = 0.892 for historic, and 0.849 for IHC integrated histotype), but the IHC integrated histotype identified more low-grade serous carcinomas and a subset of endometrioid carcinomas that were assigned as high-grade serous (n = 25). No substantial differences in histotype-specific mortality were observed across approaches. Our findings suggest that histotype assignment is fairly consistent regardless of classification approach, but that progressive improvements in classification accuracy for some less common histotypes are achieved with pathologic review using the 2014 WHO criteria and with IHC integration. We additionally recommend a classification scheme to fit historic data into the 2014 WHO categories to answer histotype-specific research questions. •Older studies can reclassify histotypes to align with the new guidelines.•Survival patterns are generally similar across histotype assignment approaches.•The most notable differences in classification were for the less common histotypes.
ISSN:0090-8258
1095-6859
DOI:10.1016/j.ygyno.2018.08.016