Abstract
Current clinical practice guidelines for patients with colorectal polyps are mainly
based on the histologic characteristics of their lesions. However, interobserver variability
in the assessment of specific polyp characteristics was evaluated in very few studies.
The purpose of this study was to evaluate the interobserver agreement of four pathologists
in the diagnosis of histologic type of colorectal polyps and in the degree of dysplasia
and of infiltrating carcinoma in adenomas. A stratified random sample of 100 polyps
was obtained from the 4,889 polyps resected within the Multicentre Adenoma Colorectal
Study (SMAC), and the slides were blindly reviewed by the four pathologists. Agreement
was analyzed using kappa statistics. A median kappa of 0.89 (range 0.79–1.0) was estimated
for the interobserver agreement for the diagnosis of hyperplastic polyp vs. adenoma.
The agreement in the diagnosis of tubular, tubulovillous, and villous type, was given
by median kappa values of 0.50, 0.15, and 0.36, respectively. The median kappa for
the diagnosis of infiltrating carcinoma was 0.78 (range 0.73–0.84). Agreement on diagnosis
of adenoma histologic subtypes, degrees of dysplasia, or infiltrating carcinoma in
adenoma was moderate. A simpler classifications might help to better identify patients
at different risk of colorectal cancer.
Keywords
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Article info
Publication history
Accepted:
November 21,
2002
Received in revised form:
September 19,
2002
Received:
April 15,
2002
Identification
Copyright
© 2003 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.
