Interobserver agreement in the histologic diagnosis of colorectal polyps the experience of the multicenter adenoma colorectal study (SMAC)

Costantini, Massimo; Sciallero, Stefania; Giannini, A. James; Gatteschi, Beatrice; Rinaldi, Paolo; Lanzanova, Giuseppe; Bonelli, Luigina; Casetti, T.; Bertinelli, E.; Giuliani, Orietta; Castiglione, Guido; Mantellini, Paola; Naldoni, Carlo; Bruzzi, Paolo

doi:10.1016/s0895-4356(02)00587-5

Cited by 84 publications

(76 citation statements)

References 27 publications

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“…65,67 Most studies find that determination of villous status (and further classification of villous adenomas) is subject to a greater degree of measurement error, with kappa values of 0.40-0.60. 65,67,69 However, in our sensitivity analyses, we found that this was not crucial to our results. Thus, it is likely that measurement error of the pathological attributes of the adenomas, although not negligible, does not significantly alter the interpretation of our results.…”

Section: Strengths and Limitationsmentioning

confidence: 60%

“…In terms of measurement error of pathological attributes of adenomas, a number of sources are available. [65][66][67][68][69] These indicate excellent histopathological measurement of adenoma size, with interobserver correlations among measures of the order of 0.98 and kappa values of the order of 0.85-0.90. 66,67 This would confer around a 2% bias in the estimates of logistic and Cox regression coefficients, 70 and around the same proportionate increase in size of 95% CIs -see Spiegelman et al 70 for mathematical details.…”

Section: Strengths and Limitationsmentioning

confidence: 75%

“…For the hospital data, it was fairly straightforward to identify such cases: cancer outcomes were defined using specific cancer histology codes (codes 50,51,55,58,59,69). However, in order to determine which cancers from external sources were outcomes of interest, they all had to be grouped based on their morphology (Derived Morph Grouping derived from morphology codes) and site (Derived Site Grouping derived from site codes).…”

Section: Cancer Outcomesmentioning

confidence: 99%

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The clinical effectiveness of different surveillance strategies to prevent colorectal cancer in people with intermediate-grade colorectal adenomas: a retrospective cohort analysis, and psychological and economic evaluations

Atkin

Brenner

Martin

et al. 2017

Health Technol Assess

131

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This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 04/33/01. The contractual start date was in September 2006. The draft report began editorial review in March 2015 and was accepted for publication in December 2015. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. Published by...

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Section: Strengths and Limitationsmentioning

confidence: 60%

Section: Strengths and Limitationsmentioning

confidence: 75%

Section: Cancer Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

The clinical effectiveness of different surveillance strategies to prevent colorectal cancer in people with intermediate-grade colorectal adenomas: a retrospective cohort analysis, and psychological and economic evaluations

Atkin

Brenner

Martin

et al. 2017

Health Technol Assess

131

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“…41 A second limitation is that pathologic classification of histologic type and grade is based on what is written in the medical record by individual pathologists contributing data to each of the tumor registries included in this study. For CRC, studies have shown fair to moderate agreement among pathologists with respect to histologic type 42,43 and histologic grade. 44 Variation in histologic grading by pathologists exists in part because of the lack of a universally accepted standardized grading system.…”

Section: Discussionmentioning

confidence: 99%

A population-based study of colorectal cancer histology in the United States, 1998–2001

Stewart

Wike

Kato

et al. 2006

Cancer

151

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“…In vast majority, CRC arise through a series of genetic mutations that activates proto-oncogenes and disable tumor suppressor genes resulting in the normal colonic epithelium to give way to precancerous adenoma development and eventually frank adenocarcinoma [3] . In last decades it has been confirmed that sporadic CRC originate from colorectal adenoma, through adenoma-carcinoma sequence [4,5] and colorectal adenomas are fairly common in the general population in that 40% of the western population will have colorectal adenoma [6,7] , but only 5-10% progress to a malignant tumor [5,8] . And recent work continues to support the adenoma-carcinoma sequence, however there is a paucity of data on the interrelationship between different genetic mutations and on the relationship between molecular and other types of genetic abnormalities [9] .…”

Section: Introductionmentioning

confidence: 99%

The Interplay between p53 and p21 Tumor Suppressor Proteins in the Transformation of Colorectal Adenoma to Carcinoma

Abdulamir¹,

Hafidh²,

Mahdi³

et al. 2008

American J. of Immunology

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This study was carried out for evaluating the interplay of p53, p21 and Ki-67 proteins along the colorectal adenoma-carcinoma oncogenic transformation sequel. Therefore, Fifty colorectal cancer and 14 adenoma patients were involved. The histopathological expression of p53, p21 and Ki-67 proteins was evaluated by immunohistochemistry assay. The results revealed that remarkable overexpression of p53 protein was seen in the tumorous sections of cancer patients more than that in adenoma patients (p<0.05), while no p53 overexpression was found in the corresponding nontumorous sections. The positive expression of p21 protein was lower in the tumorous sections of cancer patients than that of adenoma patients (p<0.05) and was higher in the non-tumorous than the corresponding tumorous sections of both CRC and adenoma patients (p<0.05). The expression of p53 and p21 proteins in cancer patients was inversely correlated to each other (p<0.05) and the expression of p21 rather than p53 protein was associated with colorectal cancer staging and grading (p<0.05). Ki-67 was higher in cancer than in adenoma patients and higher in the tumorous tissue sections than the corresponding non-tumorous sections (p<0.05). The overexpression of p53 and downexpression of p21 proteins in colorectal cancer might be responsible largely for triggering the transformational changes in normal mucosa to develop adenoma and trigger also the malignant cascade from adenoma to carcinoma. P53 overexpression was shown to occur due to the mutated dysfunctional p53 gene product which loses its transcriptional activator necessary for p21 expression. The level of p21 protein which is a quantitatively affected by the loss of p53 activation is responsible for the association with cancer staging and grading that serves as a good indicator for the disease progression.

show abstract

Interobserver agreement in the histologic diagnosis of colorectal polyps the experience of the multicenter adenoma colorectal study (SMAC)

Cited by 84 publications

References 27 publications

The clinical effectiveness of different surveillance strategies to prevent colorectal cancer in people with intermediate-grade colorectal adenomas: a retrospective cohort analysis, and psychological and economic evaluations

The clinical effectiveness of different surveillance strategies to prevent colorectal cancer in people with intermediate-grade colorectal adenomas: a retrospective cohort analysis, and psychological and economic evaluations

A population-based study of colorectal cancer histology in the United States, 1998–2001

The Interplay between p53 and p21 Tumor Suppressor Proteins in the Transformation of Colorectal Adenoma to Carcinoma

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