Standardization of Gleason grading among 337 European pathologists
Por:
Egevad, L, Ahmad, AS, Algaba, F, Berney, DM, Boccon-Gibod, L, Comperat, E, Evans, AJ, Griffiths, D, Grobholz, R, Kristiansen, G, Langner, C, Lopez-Beltran, A, Montironi, R, Moss, S, Oliveira, P, Vainer, B, Varma, M, Camparo, P
Publicada:
1 ene 2013
Resumen:
Egevad L, Ahmad A S, Algaba F, Berney D M, Boccon-Gibod L, Comperat E, Evans A J, Griffiths D, Grobholz R, Kristiansen G, Langner C, Lopez-Beltran A, Montironi R, Moss S, Oliveira P, Vainer B, Varma M & Camparo P (2013) Histopathology 62, 247-256 Standardization of Gleason grading among 337 European pathologists Aims: The 2005 International Society of Urological Pathology (ISUP) modification of Gleason grading recommended that the highest grade should always be included in the Gleason score (GS) in prostate biopsies. We analysed the impact of this recommendation on reporting of GS 6 versus 7. Methods and results: Fifteen expert uropathologists reached two-thirds consensus on 15 prostate biopsies with GS 67 cancer. Eighty-five microphotographs were graded by 337 of 617 members of the European Network of Uropathology (ENUP), representing 19 countries. There was agreement between expert and majority member GS in 12 of 15 cases, while members upgraded in three cases. Among members and the expert consensus, a GS >6 was assigned by 64.5% and 60%, respectively. Mean member GS was higher than consensus GS in nine of 15 cases. A Gleason pattern (GP) 5 was reported by 0.35.6% in 10 cases. Agreement between consensus and member GS was 58.289.3% (mean 71.4%) in GS 6 cases and 46.363.8% (mean 56.4%) in GS 7 cases (P = 0.009). Conclusions: While undergrading of prostate cancer used to be prevalent, some now tend to overgrade. Minimum diagnostic criteria for GP 4 and 5 in biopsies need to be better defined. Image libraries reviewed by experts may be useful for standardization.
Filiaciones:
Egevad, L:
Karolinska Inst, Karolinska Univ Hosp Solna, Dept Oncol Pathol, S-17176 Stockholm, Sweden
Ahmad, AS:
Queen Mary Univ London, Wolfson Inst Prevent Med, London, England
Algaba, F:
Fundacio Puigvert Univ Autonomous, Barcelona, Spain
Berney, DM:
St Bartholomews Hosp, London, England
Boccon-Gibod, L:
Hop Armand Trousseau, Paris, France
Comperat, E:
Hop La Pitie Salpetriere, Paris, France
Evans, AJ:
Univ Toronto, Toronto, ON, Canada
Griffiths, D:
Univ Wales Hosp, Cardiff CF4 4XW, S Glam, Wales
Grobholz, R:
Kantonsspital Aarau, Aarau, Switzerland
Kristiansen, G:
Univ Hosp, Bonn, Germany
Langner, C:
Med Univ, Graz, Austria
Lopez-Beltran, A:
Univ Cordoba, Sch Med, Cordoba, Spain
Montironi, R:
Polytech Univ Marche Reg, Ancona, Italy
Moss, S:
Queen Mary Univ London, Wolfson Inst Prevent Med, London, England
Oliveira, P:
Hosp da Luz, Lisbon, Portugal
Vainer, B:
Rigshosp, DK-2100 Copenhagen, Denmark
Varma, M:
Univ Wales Hosp, Cardiff CF4 4XW, S Glam, Wales
Camparo, P:
Hop Foch, Paris, France
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