Format

Send to

Choose Destination

See 1 citation found by title matching your search:

Histopathology. 2016 Aug;69(2):187-97. doi: 10.1111/his.12923. Epub 2016 Feb 14.

Interlaboratory variability in the grading of dysplasia in a nationwide cohort of colorectal adenomas.

Author information

1
Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands.
2
Foundation PALGA (the Nationwide Network and Registry of Histo- and Cytopathology in The Netherlands), Houten, The Netherlands.
3
Symbiant Pathology Expert Centre, Alkmaar, The Netherlands.
4
Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands.
5
Department of Pathology, Erasmus Medical Centre, Rotterdam, The Netherlands.
6
NVVP (Dutch Society of Pathology), Utrecht, The Netherlands.
7
Department of Pathology, VU University Medical Centre, Amsterdam, The Netherlands.
8
Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Abstract

AIMS:

Although high-grade dysplasia (HGD) is a risk factor for malignant transformation and the future development of adenomas/carcinomas, grade is not incorporated in the Dutch guidelines for colonoscopy surveillance, partly because of presumed interobserver variability. The aim of this study was to analyse, in a nationwide cohort of colorectal adenomas, the interlaboratory variability in the grading of dysplasia in daily practice.

METHODS AND RESULTS:

From the Dutch Pathology Registry, all synoptically reported classic adenomas in The Netherlands in 2013 were identified. The proportion of adenomas with HGD was determined for biopsies and polypectomies, and compared between 37 laboratories by the use of multivariable logistic regression analyses. In total, 21 030 colonoscopies of 20 270 patients were included. HGD was reported in 530 (3.6%) of 14 866 adenomas diagnosed on biopsies (range between laboratories: 0-13.6%) and in 983 (11.8%) of 8346 adenomas diagnosed on polypectomies (range: 3.1-42.9%). After adjustment for case mix, 13 (35%) laboratories reported a significantly lower or higher frequency of HGD than average.

CONCLUSIONS:

We observed considerable interlaboratory variation in the grading of dysplasia in colorectal adenomas, which could be only partly explained by differences in case mix. Therefore, better standardization of grading criteria is needed before grade of dysplasia can usefully be incorporated in colonoscopy surveillance guidelines.

KEYWORDS:

colorectal adenoma; dysplasia; grading; histopathology; variability

PMID:
26707958
DOI:
10.1111/his.12923
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center