2012
DOI: 10.1007/s00428-012-1263-6
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Training increases concordance in classifying pulmonary adenocarcinomas according to the novel IASLC/ATS/ERS classification

Abstract: The International Association for the Study of Lung Cancer (IASLC), the American Thoracic Society (ATS), and the European Respiratory Society (ERS) proposed a classification for lung adenocarcinomas (ADC) based on the predominant growth pattern. This classification has been shown to have prognostic and maybe even predictive impact. However, until now, the reproducibility of this classification has not been sufficiently demonstrated. Digital images of 40 selected ADC cases were shown twice to members of the Pul… Show more

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Cited by 50 publications
(45 citation statements)
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“…Therefore, reclassification of ADCs based on histomorphology [18] was a logical and essential step with highly significant prognostic and, probably, predictive value [9]. With this novel and largely reproducible [20,21] tool, linkage of the different ADC histotypes to diagnostic and predictive biomarkers as well as clinical characteristics is essential for a comprehensive interdisciplinary classification of ADC in the future [18]. Furthermore, different therapeutic targets were found to be associated with each other, implying combined inhibitory strategies for optimised treatment algorithms.…”
Section: Discussionmentioning
confidence: 99%
“…Therefore, reclassification of ADCs based on histomorphology [18] was a logical and essential step with highly significant prognostic and, probably, predictive value [9]. With this novel and largely reproducible [20,21] tool, linkage of the different ADC histotypes to diagnostic and predictive biomarkers as well as clinical characteristics is essential for a comprehensive interdisciplinary classification of ADC in the future [18]. Furthermore, different therapeutic targets were found to be associated with each other, implying combined inhibitory strategies for optimised treatment algorithms.…”
Section: Discussionmentioning
confidence: 99%
“…47 On the other hand, in a study of 40 difficult cases and 51 thoracic pathologists, consensus on the predominant subtype of adenocarcinoma was achieved initially in 51-74% (lepidic 57%, papillary 63%, acinar 51%, micropapillary 64% and solid 73%). 46 Training improved these results somewhat (consensus in 60-75%). 46 There is also interobserver variability in identifying the presence of invasion.…”
Section: Accepted Manuscriptmentioning
confidence: 94%
“…46 Training improved these results somewhat (consensus in 60-75%). 46 There is also interobserver variability in identifying the presence of invasion. 47 In a study involving 28 thoracic pathologists who evaluated 64 typical and difficult cases for the presence of invasion, complete agreement was seen in 10% of cases, and <10% discordance in 29% (3 point scale: probable and definite invasion, unclear, probably or definitely not invaded; κ = 0.55 for typical cases and 0.15 for difficult cases).…”
Section: Accepted Manuscriptmentioning
confidence: 94%
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“…Die Reproduzierbarkeit der Klassifikation wurde erstmals im Rahmen der AG Thoraxpathologie der Deutschen Gesellschaft für Pathologie untersucht. Hierbei zeigte sich, dass die Anwendung in der Routinediagnostik machbar erscheint, jedoch bei spezifischen Fragen der Musterinterpretation perspektivisch eine weitere Präzisierung erfolgen sollte [17,34]. Ein weiterer interessanter Aspekt der semiquantitativen Musteranalyse ergibt sich aus dem Aspekt, dass einige der Muster auch bildgeben, naturgemäß mit einigen technisch bedingten Einschränkungen, reproduzierbar sind und somit präoperativ im Rahmen von Verlaufsbeobachtungen als auch ggf.…”
Section: Prognostische Und Prädiktive Bedeutung Der Histomorphologieunclassified