Observer variability in histopathological reporting of non-small cell lung carcinoma on bronchial biopsy specimens.
OBJECTIVE
To evaluate the ability of histopathologists to sub-classify non-small cell lung carcinomas on bronchial biopsy material using the current World Health Organisation (WHO) classification.


METHODS
Twelve histopathologists each reviewed 100 randomly selected bronchial biopsy specimens which had originally been reported as showing non-small cell lung carcinoma. For each case, two sections were circulated, one stained by haematoxylin and eosin and the other by a standard method for mucin (alcian blue/periodic acid Schiff). The participants were allowed to indicate their degree of confidence in their classification of each case. A standard proforma was completed and the results were analysed using kappa statistics.


RESULTS
Where the participants were confident in their classification, they were actually quite good at sub-classifying the non-small cell carcinoma sections (kappa = 0.71, standard error = 0.058). Overall, however, the results were only fair (kappa = 0.39, standard error = 0.034).


CONCLUSIONS
The majority of non-small cell lung carcinomas can be correctly categorised on adequate bronchial biopsy material. Where a confident diagnosis was made, both squamous carcinoma (kappa = 0.73) and adenocarcinoma (kappa = 0.83) were well recognised.
Burnett
R A
RA
University of Glasgow Department of Pathology, Western Infirmary.
Howatson
S R
SR
Lang
S
S
Lee
F D
FD
Lessells
A M
AM
McLaren
K M
KM
Nairn
E R
ER
Ogston
S
S
Robertson
A J
AJ
Simpson
J G
JG
Smith
G D
GD
Tavadia
H B
HB
Walker
F
F
D000230:Adenocarcinoma / Q000473:pathology; D001706:Biopsy; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D002983:Clinical Competence; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D015588:Observer Variation; D011897:Random Allocation; D013194:Staining and Labeling / Q000379:methods