Level of interobserver variability estimation as a valuable tool: assessment of tumour budding in colon cancer

Martin, Benedikt; Schäfer, Eva; Jakubowicz, Elżbieta; Mayr, N. Patrick; Ihringer, Regina; Anthuber, Matthias; Schenkirsch, Gerhard; Schaller, Tina; Märkl, Bruno

doi:10.1111/his.13698

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…Almost all the cases with complete agreement were classified as Bd1. We could already observe in the previous study that a higher grade of tumor budding can often be excluded reliably [6]. The average bud count increased significantly from 2.6 to 3.6 buds per case, with supporting cytokeratin immunohistochemistry (p < 0.001) for all investigators.…”

Section: Discussionsupporting

confidence: 71%

“…The present study builds on two previous studies, whose methods have already been published in detail [5,6]. In brief, six investigators (I1, I2, I3, I5, I6, and I7; I4 was not designated to provide a better comparability with the previous study) with different levels of experience (two specialists (I6, and I7), four residents (I1, I2, I3, and I5)) evaluated tumor budding according to the ITBCC method (exception: only one exemplary slide per case) in an approximately everyday routine setting.…”

Section: Methodsmentioning

confidence: 99%

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Interobserver Variability in the Assessment of Tumor Budding in pT 3/4 Colon Cancer: Improvement by Supporting Immunohistochemistry?

Martin¹,

Mayr

Ihringer³

et al. 2020

Diagnostics

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The prognostic significance of tumor budding in colon cancer is unequivocally documented, and the recommendations of the International Tumor Budding Consensus Conference (ITBCC) are currently the accepted basis for its assessment. Up to now, it is unknown whether the general use of a supporting cytokeratin immunohistochemistry can improve the interobserver variability and prognostic significance. Six investigators with different levels of experience reassessed 229 cases of colon carcinoma (pT3/4, N+/−, M0) with a supporting cytokeratin immunohistochemistry. The results were compared to previous assessments, which have been performed only on H & E. Bd3 was significantly associated with the occurrence of distant metastases according to the assessments of three out of six investigators (p < 0.05). Only one single investigator reached significant results concerning the cancer specific survival (p = 0.01). The pairwise kappa values range between a poor and moderate level of agreement (range 0.17–0.45; median 0.21). In conclusion, the results show no superiority of the use of an additional cytokeratin immunohistochemistry compared to the conventional analysis on sole H & E slides. Therefore, the general supporting use of a cytokeratin immunohistochemical staining seems to be inadvisable in colon cancer in consideration of necessary resources and costs.

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Section: Discussionsupporting

confidence: 71%

Section: Methodsmentioning

confidence: 99%