Validation of an Algorithm for the Diagnosis of Serous Tubal Intraepithelial Carcinoma
Russell Vang, Kala Visvanathan, Amy Gross, Emily Maambo, Mamta Gupta, Elisabetta Kuhn, Rose (Fanghong) Li, Brigitte M Ronnett, Jeffrey D Seidman, Anna Yemelyanova, Ie-Ming Shih, Patricia A Shaw, Robert A Soslow, Robert J Kurman. The Johns Hopkins Hospital, Baltimore; The Johns Hopkins Bloomberg School of Public Health, Baltimore; Washington Hospital Center, Washington, DC; University of Toronto, University Health Network, Toronto, Canada; Memorial Sloan-Kettering Cancer Center, New York
Background: It has been reported that the diagnosis of serous tubal intraepithelial carcinoma (STIC) is not optimally reproducible based only on histologic assessment. Recently, we reported that the use of a diagnostic algorithm that combines histologic features and coordinate immunohistochemical expression of p53 and Ki-67 substantially improves reproducibility of the diagnosis. The goal of the current study was to validate this algorithm by testing a group of 6 gynecologic pathologists who had not participated in the development of the algorithm (3 faculty, 3 fellows) but who were trained in its use by referring to a website designed for that purpose.
Design: H&E, p53, and Ki-67 slides, which contained 41 mucosal lesions of the fallopian tube, were reviewed by all observers.
Results: Overall consensus (≥4 of 6 pathologists) for the 4 categories of STIC, serous tubal intraepithelial lesion (our atypical intermediate category), p53 signature, and normal/reactive was achieved in 76% of lesions with no consensus in 24%. Combining diagnoses into 2 categories (STIC vs. non-STIC) resulted in overall consensus in 93% with no consensus in 7%. The kappa value for STIC vs. non-STIC among all 6 observers was also high at 0.67 and did not significantly differ whether for faculty (κ=0.66) or fellows (κ=0.60).
Conclusions: These findings confirm the reproducibility of this algorithm by a group of gynecologic pathologists who were trained on a website for that purpose. Accordingly, we recommend its use in research studies. Before applying it in routine clinical practice, the algorithm should be evaluated by general surgical pathologists in the community setting.
Category: Gynecologic & Obstetrics
Tuesday, March 20, 2012 1:00 PM
Poster Session IV # 137, Tuesday Afternoon