1Department of Pathology, Inha University School of Medicine, Incheon, Korea
2Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
3Department of Pathology, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
4Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
5Department of Pathology, Kosin University College of Medicine, Busan, Korea
6Department of Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
7Department of Pathology, National Cancer Center, Goyang, Koreaa
8Department of Pathology, Soonchunhyang University Seoul Hospital, Seoul, Korea
9Department of Pathology, Korea University College of Medicine, Seoul, Korea
10Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
11Department of Pathology, Inje University Busan Paik Hospital, Busan, Korea
12Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
13Department of Pathology, Chonnam National University Hwasun Hospital, Hwasun, Korea
14Department of Pathology, Pusan National University College of Medicine, Busan, Korea
15Department of Pathology, Samsung Medical Cancer, Sungkyunkwan University School of Medicine, Seoul, Korea
16Department of Pathology, Department of Biomedical Sciences, Inha University School of Medicine, Incheon, Korea
17Department of Pathology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
18Department of Pathology, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Asan Digestive Disease Research Institute, Seoul, Korea
19Department of Pathology, Department of Statistics, Inha University, Incheon, Korea
20Department of Pathology, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
Copyright © 2019 by the Korean Cancer Association
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Woo Ho Kim, a contributing editor of the Cancer Research and Treatment, was not involved in the editorial evaluation or decision to publish this article. All remaining authors have declared no conflicts of interest.
Disease category | Kappa | Weighted kappa |
---|---|---|
CA/HG/LG/Others | 0.76 | 0.83 |
CA+HG/LG/Others | 0.81 | 0.82 |
CA/HG+LG/Others | 0.82 | 0.83 |
CA/HG/LG+Others | 0.83 | 0.83 |
CA+HG/LG+Others | 0.83 | 0.83 |
CA/Non-CA | 0.84 | 0.84 |
Original Dx | Final Dx |
Total | |||
---|---|---|---|---|---|
CA | HG | LG | Others | ||
CA | 692 (91.5) | 12 (19.0) | 13 (3.8) | 2 (4.9) | 719 |
HG | 43 (5.7) | 32 (50.8) | 31 (9.1) | 3 (7.3) | 109 |
LG | 20 (2.6) | 19 (30.2) | 295 (86.3) | 10 (24.4) | 344 |
Others | 1 (0.1) | 0 | 3 (0.9) | 26 (63.4) | 30 |
Total | 756 (100) | 63 (100) | 342 (100) | 41 (100) | 1,202 |
No. | Institution | Original | Final |
Total | Kappa | Weighted kappa | |||
---|---|---|---|---|---|---|---|---|---|
CA | HG | LG | RA | ||||||
1 | A | CA | 42 | 0 | 0 | 0 | 43 | 1 | 1 |
HG | 0 | 0 | 0 | 0 | |||||
LG | 0 | 0 | 1 | 0 | |||||
RA | 0 | 0 | 0 | 0 | |||||
2 | B | CA | 98 | 3 | 0 | 0 | 110 | 0.68 | 0.80 |
HG | 1 | 2 | 0 | 0 | |||||
LG | 0 | 2 | 3 | 0 | |||||
RA | 0 | 0 | 0 | 1 | |||||
3 | C | CA | 90 | 0 | 3 | 0 | 124 | 0.88 | 0.89 |
HG | 0 | 2 | 1 | 0 | |||||
LG | 1 | 1 | 26 | 0 | |||||
RA | 0 | 0 | 0 | 0 | |||||
4 | D | CA | 75 | 2 | 2 | 0 | 123 | 0.67 | 0.74 |
HG | 4 | 2 | 3 | 0 | |||||
LG | 6 | 2 | 24 | 1 | |||||
RA | 0 | 0 | 0 | 2 | |||||
5 | E | CA | 27 | 0 | 0 | 0 | 49 | 0.68 | 0.82 |
HG | 6 | 2 | 1 | 0 | |||||
LG | 0 | 0 | 8 | 2 | |||||
RA | 0 | 0 | 0 | 3 | |||||
6 | F | CA | 29 | 0 | 0 | 0 | 54 | 0.73 | 0.81 |
HG | 5 | 3 | 0 | 0 | |||||
LG | 1 | 2 | 14 | 0 | |||||
RA | 0 | 0 | 0 | 0 | |||||
7 | G | CA | 64 | 3 | 2 | 0 | 119 | 0.68 | 0.78 |
HG | 7 | 4 | 6 | 0 | |||||
LG | 2 | 1 | 28 | 0 | |||||
RA | 0 | 0 | 0 | 2 | |||||
8 | H | CA | 37 | 0 | 0 | 0 | 74 | 0.72 | 0.79 |
HG | 3 | 2 | 1 | 0 | |||||
LG | 4 | 2 | 22 | 2 | |||||
RA | 0 | 0 | 0 | 1 | |||||
9 | I | CA | 129 | 2 | 1 | 2 | 266 | 0.80 | 0.86 |
HG | 9 | 8 | 7 | 0 | |||||
LG | 2 | 6 | 89 | 3 | |||||
RA | 0 | 0 | 0 | 8 | |||||
10 | J | CA | 27 | 0 | 1 | 0 | 59 | 0.71 | 0.81 |
HG | 2 | 0 | 6 | 0 | |||||
LG | 1 | 0 | 20 | 0 | |||||
RA | 0 | 0 | 0 | 2 | |||||
11 | K | CA | 28 | 0 | 2 | 0 | 60 | 0.77 | 0.83 |
HG | 0 | 0 | 4 | 0 | |||||
LG | 1 | 1 | 22 | 0 | |||||
RA | 0 | 0 | 0 | 2 | |||||
12 | L | CA | 46 | 2 | 2 | 0 | 121 | 0.69 | 0.75 |
HG | 6 | 7 | 2 | 3 | |||||
LG | 2 | 2 | 38 | 2 | |||||
RA | 1 | 0 | 3 | 5 | |||||
Total | 756 | 63 | 342 | 41 | 1,202 |
Disease category | Kappa | Weighted kappa |
---|---|---|
CA/HG/LG/Others | 0.76 | 0.83 |
CA+HG/LG/Others | 0.81 | 0.82 |
CA/HG+LG/Others | 0.82 | 0.83 |
CA/HG/LG+Others | 0.83 | 0.83 |
CA+HG/LG+Others | 0.83 | 0.83 |
CA/Non-CA | 0.84 | 0.84 |
Magnification | Characteristic | Example (Figures) |
---|---|---|
Low | 1. Irregular size and shape of glands | 1G |
2. Irregular distribution (density) of glands | 1G | |
3. Loss of polarity of glands | 1G | |
4. Fusion of glands | 1A | |
Medium | 1. Fusion of glands | 1B, H |
2. Irregular branching | 1B, H | |
3. Small glands in lamina propria | 1D | |
High | ||
Structure | 1. Invasion | 1C, F |
2. Irregular basement membrane | 1C, F, I | |
3. Angular glands | 1B | |
Cytology | 4. Extreme atypia (hyperchromasia, pleomorphism) | 1I |
5. Round nuclei | 1C, F, I | |
6. Vesicular chromatin | 1C, F, I | |
7. Nuclear polarity loss | 1C, F, I | |
8. Surface epithelial crowding and stratification | 1E |
Characteristic | LG | HG |
---|---|---|
Structure | ||
Gland distribution | Even | Crowded |
Gland shape | Regular | Irregular/intraglandular proliferation |
Gland axis polarity | Present/loss | Loss |
Surface maturation | Present | Absent |
Nuclear stratification | Less than half | More than half |
Cytology | ||
Nuclear polarity loss | Absent | Present |
Brush border | Present | Absent/present |
Pitfall | ||
Tufting and papillae in regeneration | ||
Polarity loss of glandular axis in LG | ||
Severe nuclear stratification in LG | ||
Brush border in HG | ||
Caution when erosion, inflammation, regeneration, and/or intraglandular inflammatory cell infiltration are associated |
Values are presented as number (%). Dx, diagnosis; CA, carcinoma; HG, high-grade dysplasia; LG, low-grade dysplasia.
CA, carcinoma; HG, high-grade dysplasia; LG, low-grade dysplasia; RA, others.
CA, carcinoma; HG, high-grade dysplasia; LG, low-grade dysplasia.
LG, low-grade dysplasia; HG, high-grade dysplasia.