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

Research output: Contribution to journalArticle

Abstract

It has been reported that the diagnosis of serous tubal intraepithelial carcinoma (STIC) is not optimally reproducible on the basis of only 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 and 3 fellows) but who were trained in its use by referring to a website designed for the purpose. They then reviewed a set of microscopic slides, which contained 41 mucosal lesions of the fallopian tube. Overall consensus (Z4 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 the lesions, with no consensus in 24%. Combining diagnoses into 2 categories (STIC versus non-STIC) resulted in an overall consensus of 93% and no consensus in 7%. The j value for STIC versus non-STIC among all 6 observers was also high at 0.67 and did not significantly differ, whether for faculty (j=0.66) or fellows (j=0.60). 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 to routine clinical practice, the algorithm should be evaluated by general surgical pathologists in a community setting.

Original languageEnglish (US)
Pages (from-to)243-253
Number of pages11
JournalInternational Journal of Gynecological Pathology
Volume31
Issue number3
DOIs
StatePublished - May 1 2012

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Keywords

  • Fallopian tube
  • Reproducibility
  • Serous tubal intraepithelial carcinoma
  • p53 signature

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Obstetrics and Gynecology

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