Inter-observer Reproducibility in the Pathologic Diagnosis of Gastric Intraepithelial Neoplasia and Early Carcinoma in Endoscopic Submucosal Dissection Specimens: A Multi-center Study

Joon Mee Kim, Jin Hee Sohn, Mee Yon Cho, Woo Ho Kim, Hee Kyung Chang, Eun Sun Jung, Myeong Cherl Kook, So Young Jin, Yang Seok Chae, Young Soo Park, Mi Seon Kang, Hyunki Kim, Jae Hyuk Lee, Do Youn Park, Kyoung Mee Kim, Hoguen Kim, Young Ju Suh, Sang Yong Seol, Hwoon Yong Jung, Deuck Hwa KimNa Rae Lee, Seung Hee Park, Ji Hye You

Research output: Contribution to journalArticle

Abstract

PURPOSE: The diagnostic criteria of gastric intraepithelial neoplasia (IEN) are controversial across the world. We investigated how many discrepancies occur in the pathologic diagnosis of IEN and early gastric carcinoma in endoscopic submucosal dissection (ESD) specimens, and evaluated the reasons of the discordance. Materials and Methods: We retrospectively reviewed 1,202 ESD specimens that were originally diagnosed as gastric IEN and early carcinoma at 12 institutions. RESULTS: The final consensus diagnosis of carcinoma were 756 cases, which were originally 692 carcinomas (91.5%), 43 high-grade dysplasias (5.7%), 20 low-grade dysplasias (2.6%), and 1 others (0.1%), respectively. High- and low-grade dysplasia were finally made in 63 and 342 cases, respectively. The diagnostic concordance with the consensus diagnosis was the highest for carcinoma (91.5%), followed by low-grade dysplasia (86.3%), others (63.4%) and high-grade dysplasia (50.8%). The general kappa value was 0.83, indicating excellent concordance. The kappa values of individual institutions ranged from 0.74 to 1 and correlated with the proportion of carcinoma cases. The cases revised to a final diagnosis of carcinoma exhibited both architectural abnormalities and cytologic atypia. The main differential points between low- and high-grade dysplasias were the glandular distribution and glandular shape. Additional features such as the glandular axis, surface maturation, nuclear stratification and nuclear polarity were also important. CONCLUSION: The overall concordance of the diagnosis of gastric IEN and early carcinoma in ESD specimens was excellent. It correlated with the proportion of carcinoma cases, demonstrating that the diagnostic criteria for carcinoma are more reproducible than those for dysplasia.

Original languageEnglish
Pages (from-to)1568-1577
Number of pages10
JournalCancer research and treatment : official journal of Korean Cancer Association
Volume51
Issue number4
DOIs
Publication statusPublished - 2019 Oct 1

Fingerprint

Stomach
Carcinoma
Neoplasms
Endoscopic Mucosal Resection

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Kim, Joon Mee ; Sohn, Jin Hee ; Cho, Mee Yon ; Kim, Woo Ho ; Chang, Hee Kyung ; Jung, Eun Sun ; Kook, Myeong Cherl ; Jin, So Young ; Chae, Yang Seok ; Park, Young Soo ; Kang, Mi Seon ; Kim, Hyunki ; Lee, Jae Hyuk ; Park, Do Youn ; Kim, Kyoung Mee ; Kim, Hoguen ; Suh, Young Ju ; Seol, Sang Yong ; Jung, Hwoon Yong ; Kim, Deuck Hwa ; Lee, Na Rae ; Park, Seung Hee ; You, Ji Hye. / Inter-observer Reproducibility in the Pathologic Diagnosis of Gastric Intraepithelial Neoplasia and Early Carcinoma in Endoscopic Submucosal Dissection Specimens : A Multi-center Study. In: Cancer research and treatment : official journal of Korean Cancer Association. 2019 ; Vol. 51, No. 4. pp. 1568-1577.
@article{4a40b1bf96834104a68794a29b9e0cb0,
title = "Inter-observer Reproducibility in the Pathologic Diagnosis of Gastric Intraepithelial Neoplasia and Early Carcinoma in Endoscopic Submucosal Dissection Specimens: A Multi-center Study",
abstract = "PURPOSE: The diagnostic criteria of gastric intraepithelial neoplasia (IEN) are controversial across the world. We investigated how many discrepancies occur in the pathologic diagnosis of IEN and early gastric carcinoma in endoscopic submucosal dissection (ESD) specimens, and evaluated the reasons of the discordance. Materials and Methods: We retrospectively reviewed 1,202 ESD specimens that were originally diagnosed as gastric IEN and early carcinoma at 12 institutions. RESULTS: The final consensus diagnosis of carcinoma were 756 cases, which were originally 692 carcinomas (91.5{\%}), 43 high-grade dysplasias (5.7{\%}), 20 low-grade dysplasias (2.6{\%}), and 1 others (0.1{\%}), respectively. High- and low-grade dysplasia were finally made in 63 and 342 cases, respectively. The diagnostic concordance with the consensus diagnosis was the highest for carcinoma (91.5{\%}), followed by low-grade dysplasia (86.3{\%}), others (63.4{\%}) and high-grade dysplasia (50.8{\%}). The general kappa value was 0.83, indicating excellent concordance. The kappa values of individual institutions ranged from 0.74 to 1 and correlated with the proportion of carcinoma cases. The cases revised to a final diagnosis of carcinoma exhibited both architectural abnormalities and cytologic atypia. The main differential points between low- and high-grade dysplasias were the glandular distribution and glandular shape. Additional features such as the glandular axis, surface maturation, nuclear stratification and nuclear polarity were also important. CONCLUSION: The overall concordance of the diagnosis of gastric IEN and early carcinoma in ESD specimens was excellent. It correlated with the proportion of carcinoma cases, demonstrating that the diagnostic criteria for carcinoma are more reproducible than those for dysplasia.",
author = "Kim, {Joon Mee} and Sohn, {Jin Hee} and Cho, {Mee Yon} and Kim, {Woo Ho} and Chang, {Hee Kyung} and Jung, {Eun Sun} and Kook, {Myeong Cherl} and Jin, {So Young} and Chae, {Yang Seok} and Park, {Young Soo} and Kang, {Mi Seon} and Hyunki Kim and Lee, {Jae Hyuk} and Park, {Do Youn} and Kim, {Kyoung Mee} and Hoguen Kim and Suh, {Young Ju} and Seol, {Sang Yong} and Jung, {Hwoon Yong} and Kim, {Deuck Hwa} and Lee, {Na Rae} and Park, {Seung Hee} and You, {Ji Hye}",
year = "2019",
month = "10",
day = "1",
doi = "10.4143/crt.2019.019",
language = "English",
volume = "51",
pages = "1568--1577",
journal = "Cancer Research and Treatment",
issn = "1598-2998",
publisher = "Korean Cancer Association",
number = "4",

}

Kim, JM, Sohn, JH, Cho, MY, Kim, WH, Chang, HK, Jung, ES, Kook, MC, Jin, SY, Chae, YS, Park, YS, Kang, MS, Kim, H, Lee, JH, Park, DY, Kim, KM, Kim, H, Suh, YJ, Seol, SY, Jung, HY, Kim, DH, Lee, NR, Park, SH & You, JH 2019, 'Inter-observer Reproducibility in the Pathologic Diagnosis of Gastric Intraepithelial Neoplasia and Early Carcinoma in Endoscopic Submucosal Dissection Specimens: A Multi-center Study', Cancer research and treatment : official journal of Korean Cancer Association, vol. 51, no. 4, pp. 1568-1577. https://doi.org/10.4143/crt.2019.019

Inter-observer Reproducibility in the Pathologic Diagnosis of Gastric Intraepithelial Neoplasia and Early Carcinoma in Endoscopic Submucosal Dissection Specimens : A Multi-center Study. / Kim, Joon Mee; Sohn, Jin Hee; Cho, Mee Yon; Kim, Woo Ho; Chang, Hee Kyung; Jung, Eun Sun; Kook, Myeong Cherl; Jin, So Young; Chae, Yang Seok; Park, Young Soo; Kang, Mi Seon; Kim, Hyunki; Lee, Jae Hyuk; Park, Do Youn; Kim, Kyoung Mee; Kim, Hoguen; Suh, Young Ju; Seol, Sang Yong; Jung, Hwoon Yong; Kim, Deuck Hwa; Lee, Na Rae; Park, Seung Hee; You, Ji Hye.

In: Cancer research and treatment : official journal of Korean Cancer Association, Vol. 51, No. 4, 01.10.2019, p. 1568-1577.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Inter-observer Reproducibility in the Pathologic Diagnosis of Gastric Intraepithelial Neoplasia and Early Carcinoma in Endoscopic Submucosal Dissection Specimens

T2 - A Multi-center Study

AU - Kim, Joon Mee

AU - Sohn, Jin Hee

AU - Cho, Mee Yon

AU - Kim, Woo Ho

AU - Chang, Hee Kyung

AU - Jung, Eun Sun

AU - Kook, Myeong Cherl

AU - Jin, So Young

AU - Chae, Yang Seok

AU - Park, Young Soo

AU - Kang, Mi Seon

AU - Kim, Hyunki

AU - Lee, Jae Hyuk

AU - Park, Do Youn

AU - Kim, Kyoung Mee

AU - Kim, Hoguen

AU - Suh, Young Ju

AU - Seol, Sang Yong

AU - Jung, Hwoon Yong

AU - Kim, Deuck Hwa

AU - Lee, Na Rae

AU - Park, Seung Hee

AU - You, Ji Hye

PY - 2019/10/1

Y1 - 2019/10/1

N2 - PURPOSE: The diagnostic criteria of gastric intraepithelial neoplasia (IEN) are controversial across the world. We investigated how many discrepancies occur in the pathologic diagnosis of IEN and early gastric carcinoma in endoscopic submucosal dissection (ESD) specimens, and evaluated the reasons of the discordance. Materials and Methods: We retrospectively reviewed 1,202 ESD specimens that were originally diagnosed as gastric IEN and early carcinoma at 12 institutions. RESULTS: The final consensus diagnosis of carcinoma were 756 cases, which were originally 692 carcinomas (91.5%), 43 high-grade dysplasias (5.7%), 20 low-grade dysplasias (2.6%), and 1 others (0.1%), respectively. High- and low-grade dysplasia were finally made in 63 and 342 cases, respectively. The diagnostic concordance with the consensus diagnosis was the highest for carcinoma (91.5%), followed by low-grade dysplasia (86.3%), others (63.4%) and high-grade dysplasia (50.8%). The general kappa value was 0.83, indicating excellent concordance. The kappa values of individual institutions ranged from 0.74 to 1 and correlated with the proportion of carcinoma cases. The cases revised to a final diagnosis of carcinoma exhibited both architectural abnormalities and cytologic atypia. The main differential points between low- and high-grade dysplasias were the glandular distribution and glandular shape. Additional features such as the glandular axis, surface maturation, nuclear stratification and nuclear polarity were also important. CONCLUSION: The overall concordance of the diagnosis of gastric IEN and early carcinoma in ESD specimens was excellent. It correlated with the proportion of carcinoma cases, demonstrating that the diagnostic criteria for carcinoma are more reproducible than those for dysplasia.

AB - PURPOSE: The diagnostic criteria of gastric intraepithelial neoplasia (IEN) are controversial across the world. We investigated how many discrepancies occur in the pathologic diagnosis of IEN and early gastric carcinoma in endoscopic submucosal dissection (ESD) specimens, and evaluated the reasons of the discordance. Materials and Methods: We retrospectively reviewed 1,202 ESD specimens that were originally diagnosed as gastric IEN and early carcinoma at 12 institutions. RESULTS: The final consensus diagnosis of carcinoma were 756 cases, which were originally 692 carcinomas (91.5%), 43 high-grade dysplasias (5.7%), 20 low-grade dysplasias (2.6%), and 1 others (0.1%), respectively. High- and low-grade dysplasia were finally made in 63 and 342 cases, respectively. The diagnostic concordance with the consensus diagnosis was the highest for carcinoma (91.5%), followed by low-grade dysplasia (86.3%), others (63.4%) and high-grade dysplasia (50.8%). The general kappa value was 0.83, indicating excellent concordance. The kappa values of individual institutions ranged from 0.74 to 1 and correlated with the proportion of carcinoma cases. The cases revised to a final diagnosis of carcinoma exhibited both architectural abnormalities and cytologic atypia. The main differential points between low- and high-grade dysplasias were the glandular distribution and glandular shape. Additional features such as the glandular axis, surface maturation, nuclear stratification and nuclear polarity were also important. CONCLUSION: The overall concordance of the diagnosis of gastric IEN and early carcinoma in ESD specimens was excellent. It correlated with the proportion of carcinoma cases, demonstrating that the diagnostic criteria for carcinoma are more reproducible than those for dysplasia.

UR - http://www.scopus.com/inward/record.url?scp=85073184719&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85073184719&partnerID=8YFLogxK

U2 - 10.4143/crt.2019.019

DO - 10.4143/crt.2019.019

M3 - Article

C2 - 30971066

AN - SCOPUS:85073184719

VL - 51

SP - 1568

EP - 1577

JO - Cancer Research and Treatment

JF - Cancer Research and Treatment

SN - 1598-2998

IS - 4

ER -