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Techniques in Coloproctology
Published in: Techniques in Coloproctology 9/2016

01-09-2016 | Original Article

Interobserver variability amongst gastrointestinal pathologists in assessing prognostic parameters of malignant colorectal polyps: a cause for concern

Authors: A. Davenport, J. Morris, S. A. Pritchard, E. Salmo, M. Scott, N. Y. Haboubi

Published in: Techniques in Coloproctology | Issue 9/2016

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Abstract

Background

Malignant colorectal polyps (MCRP) have become a major challenge in the field of coloproctology from diagnosis to full treatment. One important facet of the challenge is the histopathological staging of the lesion and identifying various prognostic parameters. The primary aim of this study was to find the interobserver variation amongst 4 experienced gastrointestinal pathologists when assessing important parameters and staging systems (Haggitt, Kikuchi and Ueno) in MCRPs.

Methods

Four experienced gastrointestinal pathologists independently assessed 56 cases of MCRP, and each pathologist completed a pro forma for each case. The results were collated and statistically analysed.

Results

There was a significant variation in the assessments using the various published staging systems agreed upon on important prognostic parameters.

Conclusions

None of the staging systems used is suitable for all polyp types or has good reproducibility. There is an urgent need to make pathologists’ assessment of MCRPs easier and more reproducible.
Literature
1.
Williams JG, Pullan RD, Hill J et al (2013) Management of the malignant colorectal polyp: ACPGBI position statement. Colorectal Dis 15(Suppl 2):1–38CrossRefPubMed
2.
Bosman FT (2010) World Health Organization, International Agency for Research on Cancer. WHO classification of tumours of the digestive system. World Health Organization classification of tumours, vol 3, 4th edn. International Agency for Research on Cancer, Lyon
3.
Vieth M, Quirke P, Lambert R, von Karsa L, Risio M (2012) European guidelines for quality assurance in colorectal cancer screening and diagnosis, 1st edn–Annotations of colorectal lesions. Endoscopy 44 Suppl 3:SE131–SE139
4.
Ueno H, Murphy J, Jass JR, Mochizuki H, Talbot IC (2002) Tumour ‘budding’ as an index to estimate the potential of aggressiveness in rectal cancer. Histopathology 40:127–132CrossRefPubMed
5.
Ueno H, Mochizuki H, Hashiguchi Y et al (2004) Risk factors for an adverse outcome in early invasive colorectal carcinoma. Gastroenterology 127:385–394CrossRefPubMed
6.
Kikuchi R, Takano M, Takagi K et al (1995) Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines. Dis Colon Rectum 38:1286–1295CrossRefPubMed
7.
Haggitt RC, Glotzbach RE, Soffer EE, Wruble LD (1985) Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy. Gastroenterology 89:328–336CrossRefPubMed
8.
Kudo S (1993) Endoscopic mucosal resection of flat and depressed types of early colorectal cancer. Endoscopy 25:455–461CrossRefPubMed
9.
Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed
10.
Kitajima K, Fujimori T, Fujii S et al (2004) Correlations between lymph node metastasis and depth of submucosal invasion in submucosal invasive colorectal carcinoma: a Japanese collaborative study. J Gastroenterol 39:534–543CrossRefPubMed
11.
Komuta K, Batts K, Jessurun J et al (2004) Interobserver variability in the pathological assessment of malignant colorectal polyps. Br J Surg 91:1479–1484CrossRefPubMed
12.
13.
14.
Zinicola R, Hill J, Fiocca R (2015) Surgery for colorectal polyps: histological features, current indications, critical points, future perspective and ongoing studies. Colorectal Dis 17(Suppl 1):52–60CrossRefPubMed
15.
Quirke P, Risio M, Lambert R, von Karsa L, Vieth M (2012) European guidelines for quality assurance in colorectal cancer screening and diagnosis. 1st edn. Quality assurance in pathology in colorectal cancer screening and diagnosis. Endoscopy 44 Suppl 3:SE116–SE130
16.
Wang LM, Sheahan K (2011) Prognostic markers in colorectal pathology: is morphology enough? Diagn Histopathol 17:386–394CrossRef
17.
18.
Sohn DK, Chang HJ, Park JW et al (2007) Histopathological risk factors for lymph node metastasis in submucosal invasive colorectal carcinoma of pedunculated or semipedunculated type. J Clin Pathol 60:912–915CrossRefPubMed
19.
Beaton C, Twine CP, Williams GL, Radcliffe AG (2013) Systematic review and meta-analysis of histopathological factors influencing the risk of lymph node metastasis in early colorectal cancer. Colorectal Dis 15:788–797CrossRefPubMed
20.
Mitrovic B, Schaeffer DF, Riddell RH, Kirsch R (2012) Tumor budding in colorectal carcinoma: time to take notice. Mod Pathol 25:1315–1325CrossRefPubMed
21.
Wang LM, Guy R, Fryer E et al (2015) Ueno method substaging pT1 colorectal adenocarcinoma by depth and width measurement: an inter-observer study. Colorectal Dis 17:674–681CrossRefPubMed
22.
Haboubi N, Salmo E (2013) Are we accurately measuring the depth of the submucosal invasion in early colorectal cancer by equating the Kikuchi submucosa levels with distances measured in fractions of a millimetre? Colorectal Dis 15:775–777CrossRefPubMed
Metadata
Title
Interobserver variability amongst gastrointestinal pathologists in assessing prognostic parameters of malignant colorectal polyps: a cause for concern
Authors
A. Davenport
J. Morris
S. A. Pritchard
E. Salmo
M. Scott
N. Y. Haboubi
Publication date
01-09-2016
Publisher
Springer International Publishing
Published in
Techniques in Coloproctology / Issue 9/2016
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-016-1513-8

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