Validation of interobserver agreement in lung cancer assessment: Hematoxylin-eosin diagnostic reproducibility for non-small cell lung cancer: The 2004 world health organization classification and therapeutically relevant subsets

Juneko E. Grilley-Olson, D. Neil Hayes, Dominic T. Moore, Kevin O. Leslie, Matthew D. Wilkerson, Bahjat F. Qaqish, Michele C. Hayward, Christopher R. Cabanski, Xiaoying Yin, Mark A. Socinski, Thomas E. Stinchcombe, Leigh B. Thorne, Timothy Craig Allen, Peter M. Banks, Mary B. Beasley, Alain C. Borczuk, Philip T. Cagle, Rebecca Christensen, Thomas V. Colby, Georgean G. DebloisGöran Elmberger, Paolo Graziano, Craig F. Hart, Kirk D. Jones, Diane M. Maia, C. Ryan Miller, Keith V. Nance, William D. Travis, William K. Funkhouser

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Context.-Precise subtype diagnosis of non-small cell lung carcinoma is increasingly relevant, based on the availability of subtype-specific therapies, such as bevacizumab and pemetrexed, and based on the subtype-specific prevalence of activating epidermal growth factor receptor mutations. Objectives.-To establish a baseline measure of interobserver reproducibility for non-small cell lung carcinoma diagnoses with hematoxylin-eosin for the current 2004 World Health Organization classification, to estimate interobserver reproducibility for the therapeutically relevant squamous/nonsquamous subsets, and to examine characteristics that improve interobserver reproducibility. Design.-Primary, resected lung cancer specimens were converted to digital (virtual) slides. Based on a single hematoxylin-eosin virtual slide, pathologists were asked to assign a diagnosis using the 2004 World Health Organization classification. Kappa statistics were calculated for each pathologist-pair for each slide and were summarized by classification scheme, pulmonary pathology expertise, diagnostic confidence, and neoplastic grade. Results.-The 12 pulmonary pathology experts and the 12 community pathologists each independently diagnosed 48 to 96 single hematoxylin-eosin digital slides derived from 96 cases of non-small cell lung carcinoma resection. Overall agreement improved with simplification from the comprehensive 44 World Health Organization diagnoses (k = 0.25) to their 10 major header subtypes (k = 0.48) and improved again with simplification into the therapeutically relevant squamous/nonsquamous dichotomy (k = 0.55). Multivariate analysis showed that higher diagnostic agreement was associated with better differentiation, better slide quality, higher diagnostic confidence, similar years of pathology experience, and pulmonary pathology expertise. Conclusions.-These data define the baseline diagnostic agreement for hematoxylin-eosin diagnosis of non-small cell lung carcinoma, allowing future studies to test for improved diagnostic agreement with reflex ancillary tests.

Original languageEnglish (US)
Pages (from-to)32-40
Number of pages9
JournalArchives of Pathology and Laboratory Medicine
Volume137
Issue number1
DOIs
StatePublished - Jan 2013
Externally publishedYes

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Hematoxylin
Eosine Yellowish-(YS)
Non-Small Cell Lung Carcinoma
Lung Neoplasms
Pathology
Lung
Pemetrexed
Epidermal Growth Factor Receptor
Routine Diagnostic Tests
Reflex
Multivariate Analysis
Mutation
Pathologists
Therapeutics

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

Validation of interobserver agreement in lung cancer assessment : Hematoxylin-eosin diagnostic reproducibility for non-small cell lung cancer: The 2004 world health organization classification and therapeutically relevant subsets. / Grilley-Olson, Juneko E.; Hayes, D. Neil; Moore, Dominic T.; Leslie, Kevin O.; Wilkerson, Matthew D.; Qaqish, Bahjat F.; Hayward, Michele C.; Cabanski, Christopher R.; Yin, Xiaoying; Socinski, Mark A.; Stinchcombe, Thomas E.; Thorne, Leigh B.; Allen, Timothy Craig; Banks, Peter M.; Beasley, Mary B.; Borczuk, Alain C.; Cagle, Philip T.; Christensen, Rebecca; Colby, Thomas V.; Deblois, Georgean G.; Elmberger, Göran; Graziano, Paolo; Hart, Craig F.; Jones, Kirk D.; Maia, Diane M.; Miller, C. Ryan; Nance, Keith V.; Travis, William D.; Funkhouser, William K.

In: Archives of Pathology and Laboratory Medicine, Vol. 137, No. 1, 01.2013, p. 32-40.

Research output: Contribution to journalArticle

Grilley-Olson, JE, Hayes, DN, Moore, DT, Leslie, KO, Wilkerson, MD, Qaqish, BF, Hayward, MC, Cabanski, CR, Yin, X, Socinski, MA, Stinchcombe, TE, Thorne, LB, Allen, TC, Banks, PM, Beasley, MB, Borczuk, AC, Cagle, PT, Christensen, R, Colby, TV, Deblois, GG, Elmberger, G, Graziano, P, Hart, CF, Jones, KD, Maia, DM, Miller, CR, Nance, KV, Travis, WD & Funkhouser, WK 2013, 'Validation of interobserver agreement in lung cancer assessment: Hematoxylin-eosin diagnostic reproducibility for non-small cell lung cancer: The 2004 world health organization classification and therapeutically relevant subsets', Archives of Pathology and Laboratory Medicine, vol. 137, no. 1, pp. 32-40. https://doi.org/10.5858/arpa.2012-0033-OA
Grilley-Olson, Juneko E. ; Hayes, D. Neil ; Moore, Dominic T. ; Leslie, Kevin O. ; Wilkerson, Matthew D. ; Qaqish, Bahjat F. ; Hayward, Michele C. ; Cabanski, Christopher R. ; Yin, Xiaoying ; Socinski, Mark A. ; Stinchcombe, Thomas E. ; Thorne, Leigh B. ; Allen, Timothy Craig ; Banks, Peter M. ; Beasley, Mary B. ; Borczuk, Alain C. ; Cagle, Philip T. ; Christensen, Rebecca ; Colby, Thomas V. ; Deblois, Georgean G. ; Elmberger, Göran ; Graziano, Paolo ; Hart, Craig F. ; Jones, Kirk D. ; Maia, Diane M. ; Miller, C. Ryan ; Nance, Keith V. ; Travis, William D. ; Funkhouser, William K. / Validation of interobserver agreement in lung cancer assessment : Hematoxylin-eosin diagnostic reproducibility for non-small cell lung cancer: The 2004 world health organization classification and therapeutically relevant subsets. In: Archives of Pathology and Laboratory Medicine. 2013 ; Vol. 137, No. 1. pp. 32-40.
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abstract = "Context.-Precise subtype diagnosis of non-small cell lung carcinoma is increasingly relevant, based on the availability of subtype-specific therapies, such as bevacizumab and pemetrexed, and based on the subtype-specific prevalence of activating epidermal growth factor receptor mutations. Objectives.-To establish a baseline measure of interobserver reproducibility for non-small cell lung carcinoma diagnoses with hematoxylin-eosin for the current 2004 World Health Organization classification, to estimate interobserver reproducibility for the therapeutically relevant squamous/nonsquamous subsets, and to examine characteristics that improve interobserver reproducibility. Design.-Primary, resected lung cancer specimens were converted to digital (virtual) slides. Based on a single hematoxylin-eosin virtual slide, pathologists were asked to assign a diagnosis using the 2004 World Health Organization classification. Kappa statistics were calculated for each pathologist-pair for each slide and were summarized by classification scheme, pulmonary pathology expertise, diagnostic confidence, and neoplastic grade. Results.-The 12 pulmonary pathology experts and the 12 community pathologists each independently diagnosed 48 to 96 single hematoxylin-eosin digital slides derived from 96 cases of non-small cell lung carcinoma resection. Overall agreement improved with simplification from the comprehensive 44 World Health Organization diagnoses (k = 0.25) to their 10 major header subtypes (k = 0.48) and improved again with simplification into the therapeutically relevant squamous/nonsquamous dichotomy (k = 0.55). Multivariate analysis showed that higher diagnostic agreement was associated with better differentiation, better slide quality, higher diagnostic confidence, similar years of pathology experience, and pulmonary pathology expertise. Conclusions.-These data define the baseline diagnostic agreement for hematoxylin-eosin diagnosis of non-small cell lung carcinoma, allowing future studies to test for improved diagnostic agreement with reflex ancillary tests.",
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T2 - Hematoxylin-eosin diagnostic reproducibility for non-small cell lung cancer: The 2004 world health organization classification and therapeutically relevant subsets

AU - Grilley-Olson, Juneko E.

AU - Hayes, D. Neil

AU - Moore, Dominic T.

AU - Leslie, Kevin O.

AU - Wilkerson, Matthew D.

AU - Qaqish, Bahjat F.

AU - Hayward, Michele C.

AU - Cabanski, Christopher R.

AU - Yin, Xiaoying

AU - Socinski, Mark A.

AU - Stinchcombe, Thomas E.

AU - Thorne, Leigh B.

AU - Allen, Timothy Craig

AU - Banks, Peter M.

AU - Beasley, Mary B.

AU - Borczuk, Alain C.

AU - Cagle, Philip T.

AU - Christensen, Rebecca

AU - Colby, Thomas V.

AU - Deblois, Georgean G.

AU - Elmberger, Göran

AU - Graziano, Paolo

AU - Hart, Craig F.

AU - Jones, Kirk D.

AU - Maia, Diane M.

AU - Miller, C. Ryan

AU - Nance, Keith V.

AU - Travis, William D.

AU - Funkhouser, William K.

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N2 - Context.-Precise subtype diagnosis of non-small cell lung carcinoma is increasingly relevant, based on the availability of subtype-specific therapies, such as bevacizumab and pemetrexed, and based on the subtype-specific prevalence of activating epidermal growth factor receptor mutations. Objectives.-To establish a baseline measure of interobserver reproducibility for non-small cell lung carcinoma diagnoses with hematoxylin-eosin for the current 2004 World Health Organization classification, to estimate interobserver reproducibility for the therapeutically relevant squamous/nonsquamous subsets, and to examine characteristics that improve interobserver reproducibility. Design.-Primary, resected lung cancer specimens were converted to digital (virtual) slides. Based on a single hematoxylin-eosin virtual slide, pathologists were asked to assign a diagnosis using the 2004 World Health Organization classification. Kappa statistics were calculated for each pathologist-pair for each slide and were summarized by classification scheme, pulmonary pathology expertise, diagnostic confidence, and neoplastic grade. Results.-The 12 pulmonary pathology experts and the 12 community pathologists each independently diagnosed 48 to 96 single hematoxylin-eosin digital slides derived from 96 cases of non-small cell lung carcinoma resection. Overall agreement improved with simplification from the comprehensive 44 World Health Organization diagnoses (k = 0.25) to their 10 major header subtypes (k = 0.48) and improved again with simplification into the therapeutically relevant squamous/nonsquamous dichotomy (k = 0.55). Multivariate analysis showed that higher diagnostic agreement was associated with better differentiation, better slide quality, higher diagnostic confidence, similar years of pathology experience, and pulmonary pathology expertise. Conclusions.-These data define the baseline diagnostic agreement for hematoxylin-eosin diagnosis of non-small cell lung carcinoma, allowing future studies to test for improved diagnostic agreement with reflex ancillary tests.

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