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  • Ericson Lindquist, KajsaLund University,Lunds universitet,Patologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Pathology, Lund,Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Region Skåne (author)

Difficulties in diagnostics of lung tumours in biopsies : an interpathologist concordance study evaluating the international diagnostic guidelines

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • 2021-02-05
  • BMJ Publishing Group Ltd,2022
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-465260
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-465260URI
  • https://doi.org/10.1136/jclinpath-2020-207257DOI
  • https://lup.lub.lu.se/record/38b8149a-0c14-4751-9433-f209bd9535d1URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:148292956URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • AIMS: Accurate and reliable diagnosis is essential for lung cancer treatment. The study aim was to investigate interpathologist diagnostic concordance for pulmonary tumours according to WHO diagnostic criteria.METHODS: Fifty-two unselected lung and bronchial biopsies were diagnosed by a thoracic pathologist based on a broad spectrum of immunohistochemical (IHC) stainings, molecular data and clinical/radiological information. Slides stained with H&E, thyroid transcription factor-1 (TTF-1) clone SPT24 and p40 were scanned and provided digitally to 20 pathologists unaware of reference diagnoses. The pathologists independently diagnosed the cases and stated if further diagnostic markers were deemed necessary.RESULTS: In 31 (60%) of the cases, ≥80% of the pathologists agreed with each other and with the reference diagnosis. Lower agreement was seen in non-small cell neuroendocrine tumours and in squamous cell carcinoma with diffuse TTF-1 positivity. Agreement with the reference diagnosis ranged from 26 to 45 (50%-87%) for the individual pathologists. The pathologists requested additional IHC staining in 15-44 (29%-85%) of the 52 cases. In nearly half (17 of 36) of the malignant cases, one or more pathologist advocated for a different final diagnosis than the reference without need of additional IHC markers, potentially leading to different clinical treatment.CONCLUSIONS: Interpathologist diagnostic agreement is moderate for small unselected bronchial and lung biopsies based on a minimal panel of markers. Neuroendocrine morphology is sometimes missed and TTF-1 clone SPT24 should be interpreted with caution. Our results suggest an intensified education need for thoracic pathologists and a more generous use of diagnostic IHC markers.

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  • Ciornei, CristinaRegion Skåne(Swepub:lu)anes-cci (author)
  • Westbom-Fremer, SofiaLund University,Lunds universitet,Bröst- och ovarialcancer,Forskargrupper vid Lunds universitet,Breast and Ovarian Cancer Genomics,Lund University Research Groups,Region Skåne(Swepub:lu)so4231we (author)
  • Gudinaviciene, IngaRegion Skåne (author)
  • Ehinger, AnnaLund University,Lunds universitet,Patologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Pathology, Lund,Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Region Skåne(Swepub:lu)pat-amm (author)
  • Mylona, NektariaRegion Skåne (author)
  • Urdar, RodrigoRegion Skåne (author)
  • Lianou, MariaLund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Region Skåne(Swepub:lu)ma3688li (author)
  • Svensson, FranziskaHalmstad County Hospital (author)
  • Seidal, TomasHalmstad County Hospital (author)
  • Haglund, FelixKarolinska Institutet (author)
  • Dobra, KatalinKarolinska Institutet,Karolinska Institute,Karolinska University Hospital(Swepub:lu)ka8805do (author)
  • Béndek, MátyásKarolinska University Hospital (author)
  • Bardóczi, ErikaKarolinska University Hospital (author)
  • Szablewska, AnetaBlekinge Hospital (author)
  • Witkowski, MarekKalmar County Hospital (author)
  • Ramnefjell, MariaHaukeland University Hospital (author)
  • De Las Casas, Luis EUniversity of Texas Southwestern Medical Center (author)
  • Gulyas, Miklos,MD, PhD, Associate Professor,1959-Uppsala University,Uppsala universitet,Klinisk och experimentell patologi,Uppsala University Hospital(Swepub:uu)mikgu245 (author)
  • Hegedus, AgnesUppsala University,Uppsala universitet,Klinisk och experimentell patologi,Uppsala University Hospital(Swepub:uu)agnhe820 (author)
  • Micke, PatrickUppsala University,Uppsala universitet,Klinisk och experimentell patologi,Patrick Micke,Uppsala University Hospital(Swepub:uu)patmi676 (author)
  • Brunnström, HansLund University,Lunds universitet,Förbättrad diagnostik och prognostik vid lungcancer och metastaser till lunga,Forskargrupper vid Lunds universitet,Improved diagnostics and prognostics of lung cancer and metastases to the lungs,Lund University Research Groups,Region Skåne(Swepub:lu)med-hsb (author)
  • Patologi, LundSektion V (creator_code:org_t)

Related titles

  • In:Journal of Clinical Pathology: BMJ Publishing Group Ltd75:5, s. 302-3090021-97461472-4146

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