title: Interobserver reproducibility of Gleason grading of prostatic carcinoma: general pathologist.
abstract: Only a few large studies of interobserver reproducibility of Gleason grading of prostatic carcinoma exist. Thirty-eight biopsies containing prostate cancer were distributed for Gleason grading to 41 general pathologists in Georgia. These cases had "consensus" Gleason grade groups (2-4, 5-6, 7, and 8-10) that were agreed on by at least 7 of 10 urologic pathologists. The overall kappa (kappa) coefficient for interobserver agreement for these 38 cases was 0.435, barely moderate agreement, with a kappa range from 0.00 to 0.88. There was consistent undergrading of Gleason scores 5-6 (47%), 7 (47%) and, to a lesser extent, 8-10 (25%). In cases with consensus primary patterns, there was consistent undergrading of patterns 2 (32%), 3 (39%), and 5 (30%). Pattern 2 was often (17%) mistaken for pattern 3. Pattern 4 was often undergraded (21%) and also mistaken for pattern 5 (17%). The most significant (P < .005) demographic factor associated with better interobserver agreement was having learned Gleason grading at a meeting or course. We believe that Gleason grading can be learned to a satisfactory level of interobserver reproducibility and have undertaken additional studies that support this belief.
authors.affiliation: Department of Pathology and Office of Biostatistics, Medical College of Georgia, Augusta, GA 30912, USA.
authors.forename: W C
authors.initials: WC
authors.lastname: Allsbrook
authors.forename: K A
authors.initials: KA
authors.lastname: Mangold
authors.forename: M H
authors.initials: MH
authors.lastname: Johnson
authors.forename: R B
authors.initials: RB
authors.lastname: Lane
authors.forename: C G
authors.initials: CG
authors.lastname: Lane
authors.forename: J I
authors.initials: JI
authors.lastname: Epstein
mesh_terms: D006801:Humans; D008297:Male; D009367:Neoplasm Staging / Q000379:methods / Q000592:standards; D015588:Observer Variation; D010338:Pathology, Clinical; D011467:Prostate / Q000473:pathology; D011471:Prostatic Neoplasms / Q000473:pathology*; D015203:Reproducibility of Results