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Type: Artigo
Title: Gleason Grade 4 Prostate Adenocarcinoma Patterns: An Interobserver Agreement Study Among Genitourinary Pathologists
Author: Kweldam
Charlotte F.; Nieboer
Daan; Algaba
Ferran; Amin
Mahul B.; Berney
Dan M.; Billis
Athanase; Bostwick
David G.; Bubendorf
Lukas; Cheng
Liang; Comperat
Eva; Delahunt
Brett; Egevad
Lars; Evans
Andrew J.; Hansel
Donna E.; Humphrey
Peter A.; Kristiansen
Glen; van der Kwast
Theodorus H.; Magi-Galluzzi
Cristina; Montironi
Rodolfo; Netto
George J.; Samaratunga
Hemamali; Srigley
John R.; Tan
Puay H.; Varma
Murali; Zhou
Ming; van Leenders
Geert J. L. H.
Abstract: To assess the interobserver reproducibility of individual Gleason grade 4 growth patterns. Methods and resultsTwenty-three genitourinary pathologists participated in the evaluation of 60 selected high-magnification photographs. The selection included 10 cases of Gleason grade 3, 40 of Gleason grade 4 (10 per growth pattern), and 10 of Gleason grade 5. Participants were asked to select a single predominant Gleason grade per case (3, 4, or 5), and to indicate the predominant Gleason grade 4 growth pattern, if present. Consensus' was defined as at least 80% agreement, and favoured' as 60-80% agreement. Consensus on Gleason grading was reached in 47 of 60 (78%) cases, 35 of which were assigned to grade 4. In the 13 non-consensus cases, ill-formed (6/13, 46%) and fused (7/13, 54%) patterns were involved in the disagreement. Among the 20 cases where at least one pathologist assigned the ill-formed growth pattern, none (0%, 0/20) reached consensus. Consensus for fused, cribriform and glomeruloid glands was reached in 2%, 23% and 38% of cases, respectively. In nine of 35 (26%) consensus Gleason grade 4 cases, participants disagreed on the growth pattern. Six of these were characterized by large epithelial proliferations with delicate intervening fibrovascular cores, which were alternatively given the designation fused or cribriform growth pattern (complex fused'). ConclusionsConsensus on Gleason grade 4 growth pattern was predominantly reached on cribriform and glomeruloid patterns, but rarely on ill-formed and fused glands. The complex fused glands seem to constitute a borderline pattern of unknown prognostic significance on which a consensus could not be reached.
Subject: Gleason Grading
Interobserver Variability
Prostate Cancer
Editor: Wiley-Blackwell
Rights: fechado
Identifier DOI: 10.1111/his.12976
Date Issue: 2016
Appears in Collections:Unicamp - Artigos e Outros Documentos

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