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Interobserver reproducibility of perineural invasion of prostatic adenocarcinoma in needle biopsies

Egevad, Lars (author)
Karolinska Institutet,Karolinska Inst, Karolinska Univ Hosp, Dept Oncol & Pathol, Radiumhemmet P1 02, S-17176 Stockholm, Sweden
Delahunt, Brett (author)
Univ Otago, Wellington Sch Med & Hlth Sci, Dept Pathol & Mol Med, Wellington, New Zealand
Samaratunga, Hemamali (author)
Aquesta Uropathol, Brisbane, Qld, Australia; Univ Queensland, Brisbane, Qld, Australia
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Tsuzuki, Toyonori (author)
AichiMed Univ, Sch Med, Dept Surg Pathol, Nagoya, Aichi, Japan
Olsson, Henrik (author)
Karolinska Institutet,Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden
Ström, Peter (author)
Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden
Lindskog, Cecilia (author)
Uppsala universitet,Klinisk och experimentell patologi
Häkkinen, Tomi (author)
Tampere Univ, Fac Med & Hlth Technol, Tampere, Finland; Tampere Univ Hosp, Tays Canc Ctr, Tampere, Finland
Kartasalo, Kimmo (author)
Karolinska Institutet,Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden; Tampere Univ, Fac Med & Hlth Technol, Tampere, Finland
Eklund, Martin (author)
Karolinska Institutet,Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden
Ruusuvuori, Pekka (author)
Tampere Univ, Fac Med & Hlth Technol, Tampere, Finland; Univ Turku, Inst Biomed, Turku, Finland
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 (creator_code:org_t)
2021-02-03
2021
English.
In: Virchows Archiv. - : Springer Nature. - 0945-6317 .- 1432-2307. ; 478:6, s. 1109-1116
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Numerous studies have shown a correlation between perineural invasion (PNI) in prostate biopsies and outcome. The reporting of PNI varies widely in the literature. While the interobserver variability of prostate cancer grading has been studied extensively, less is known regarding the reproducibility of PNI. A total of 212 biopsy cores from a population-based screening trial were included in this study (106 with and 106 without PNI according to the original pathology reports). The glass slides were scanned and circulated among four pathologists with a special interest in urological pathology for assessment of PNI. Discordant cases were stained by immunohistochemistry for S-100 protein. PNI was diagnosed by all four observers in 34.0% of cases, while 41.5% were considered to be negative for PNI. In 24.5% of cases, there was a disagreement between the observers. The kappa for interobserver variability was 0.67-0.75 (mean 0.73). The observations from one participant were compared with data from the original reports, and a kappa for intraobserver variability of 0.87 was achieved. Based on immunohistochemical findings among discordant cases, 88.6% had PNI while 11.4% did not. The most common diagnostic pitfall was the presence of bundles of stroma or smooth muscle. It was noted in a few cases that collagenous micronodules could be mistaken for a nerve. The distance between cancer and nerve was another cause of disagreement. Although the results suggest that the reproducibility of PNI may be greater than that of prostate cancer grading, there is still a need for improvement and standardization.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Keyword

Pathology
Reproducibility
Perineural invasion
Prostate cancer

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