title: Validation of an algorithm for the diagnosis of serous tubal intraepithelial carcinoma.
abstract: It has been reported that the diagnosis of serous tubal intraepithelial carcinoma (STIC) is not optimally reproducible on the basis of only histologic assessment. Recently, we reported that the use of a diagnostic algorithm that combines histologic features and coordinate immunohistochemical expression of p53 and Ki-67 substantially improves reproducibility of the diagnosis. The goal of the current study was to validate this algorithm by testing a group of 6 gynecologic pathologists who had not participated in the development of the algorithm (3 faculty and 3 fellows) but who were trained in its use by referring to a website designed for the purpose. They then reviewed a set of microscopic slides, which contained 41 mucosal lesions of the fallopian tube. Overall consensus (≥4 of 6 pathologists) for the 4 categories of STIC, serous tubal intraepithelial lesion (our atypical intermediate category), p53 signature, and normal/reactive was achieved in 76% of the lesions, with no consensus in 24%. Combining diagnoses into 2 categories (STIC versus non-STIC) resulted in an overall consensus of 93% and no consensus in 7%. The κ value for STIC versus non-STIC among all 6 observers was also high at 0.67 and did not significantly differ, whether for faculty (κ=0.66) or fellows (κ=0.60). These findings confirm the reproducibility of this algorithm by a group of gynecologic pathologists who were trained on a website for that purpose. Accordingly, we recommend its use in research studies. Before applying it to routine clinical practice, the algorithm should be evaluated by general surgical pathologists in a community setting.
authors.affiliation: Departments of Pathology, Division of Gynecologic Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA. rvang1@jhmi.edu
authors.forename: Russell
authors.initials: R
authors.lastname: Vang
authors.forename: Kala
authors.initials: K
authors.lastname: Visvanathan
authors.forename: Amy
authors.initials: A
authors.lastname: Gross
authors.forename: Emily
authors.initials: E
authors.lastname: Maambo
authors.forename: Mamta
authors.initials: M
authors.lastname: Gupta
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Kuhn
authors.forename: Rose Fanghong
authors.initials: RF
authors.lastname: Li
authors.forename: Brigitte M
authors.initials: BM
authors.lastname: Ronnett
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Seidman
authors.forename: Anna
authors.initials: A
authors.lastname: Yemelyanova
authors.forename: Ie-Ming
authors.initials: IeM
authors.lastname: Shih
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Shaw
authors.forename: Robert A
authors.initials: RA
authors.lastname: Soslow
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Kurman
mesh_terms: D000465:Algorithms; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D005185:Fallopian Tube Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D015588:Observer Variation; D015203:Reproducibility of Results; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53