title: Analysis of interobserver reproducibility in grading histological patterns of dysplastic nevi.
abstract: BACKGROUND
  Dysplastic nevi are among the most important cutaneous melanoma simulators. They are important risk markers for this neoplasia and can be its potential precursors. Some authors found a statistically significant relationship between the degree of dysplasia and the risk for developing melanoma. However, reproducibility of grading criteria ranged from poor to fair in the researched articles.
  
  
  OBJECTIVE
  To test the reproducibility of the grading criteria proposed by Sagebiel et al. regarding dysplastic nevi.
  
  
  METHODS
  Histological specimens of 75 dysplastic nevi were graded, independently and in a blinded fashion, according to preestablished criteria, by a panel of 10 pathologists with different levels of experience. Diagnostic agreement was calculated using weighted kappa and intraclass correlation coefficients.
  
  
  RESULTS
  The average of weighted kappa values was 0.13 for all observers, 0.12 for dermatopathologists, 0.18 for general pathologists and 0.05 for residents. Intraclass correlation coefficient values were 0.2 for all observers, 0.18 for dermatopathologists, 0.33 for general pathologists and 0.15 for residents.
  
  
  CONCLUSIONS
  Histopathological grading for dysplastic nevi was not reproducible in this Brazilian series, so the criteria used are not a helpful histopathological parameter for clinicopathological correlation.
authors.affiliation: Instituto Nacional de Câncer (National Cancer Institute -INCA) -, Rio de Janeiro, RJ, Brazil. arethanobre@yahoo.com.br
authors.forename: Aretha Brito
authors.initials: AB
authors.lastname: Nobre
authors.forename: Juan
authors.initials: J
authors.lastname: Piñeiro-Maceira
authors.forename: Ronir Raggio
authors.initials: RR
authors.lastname: Luiz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D002648:Child; D004416:Dysplastic Nevus Syndrome / Q000145:classification / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009508:Nevus, Pigmented / Q000473:pathology*; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*; D055815:Young Adult
references.citation: Eur J Cancer. 2005 Jan;41(1):28-44
references.pmid: 15617989
references.citation: Mod Pathol. 2006 Feb;19 Suppl 2:S4-20
references.pmid: 16446715
references.citation: J Am Acad Dermatol. 2001 Jul;45(1):77-85
references.pmid: 11423839
references.citation: Histopathology. 1994 Jun;24(6):503-9
references.pmid: 8063279
references.citation: Arch Dermatol. 2003 Oct;139(10):1374-5
references.pmid: 14568850
references.citation: J Cutan Pathol. 2005 Jul;32(6):405-12
references.pmid: 15953373
references.citation: J Am Acad Dermatol. 1985 Dec;13(6):975-82
references.pmid: 4078104
references.citation: Histopathology. 1999 Mar;34(3):189-98
references.pmid: 10217558
references.citation: J Invest Dermatol. 1993 Mar;100(3):318S-321S
references.pmid: 8440913
references.citation: Cancer. 1989 Jan 15;63(2):386-9
references.pmid: 2910446
references.citation: Biometrics. 1977 Mar;33(1):159-74
references.pmid: 843571
references.citation: J Am Acad Dermatol. 2010 Apr;62(4):591-6
references.pmid: 20018406
references.citation: Br J Dermatol. 2006 Nov;155(5):988-93
references.pmid: 17034530
references.citation: Mod Pathol. 1989 Jul;2(4):306-19
references.pmid: 2762287
references.citation: Arch Dermatol. 1978 May;114(5):732-8
references.pmid: 646394
references.citation: J Am Acad Dermatol. 1992 Nov;27(5 Pt 1):741-9
references.pmid: 1430397
references.citation: Mod Pathol. 2003 Aug;16(8):764-71
references.pmid: 12920220
references.citation: J Am Acad Dermatol. 1994 May;30(5 Pt 1):707-14
references.pmid: 8176008