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Interobserver and intraobserver variation in themorphological evaluation of noninvasive follicular thyroid neoplasm with papillary-like nuclear features in Asian practice

Authors
 Zhiyan Liu  ;  Andrey Bychkov  ;  Chan Kwon Jung  ;  Mitsuyoshi Hirokawa  ;  Shaofeng Sui  ;  SoonWon Hong  ;  Chiung‐Ru Lai  ;  Deepali Jain  ;  Sule Canberk  ;  Kennichi Kakudo 
Citation
 PATHOLOGY INTERNATIONAL, Vol.69(4) : 202-210, 2019 
Journal Title
 PATHOLOGY INTERNATIONAL 
ISSN
 1320-5463 
Issue Date
2019
MeSH
Adenocarcinoma, Follicular/diagnosis ; Adenocarcinoma, Follicular/genetics ; Adenocarcinoma, Follicular/pathology ; Amino Acid Substitution ; Asian Continental Ancestry Group ; Biopsy, Fine-Needle ; Cell Nucleus/pathology ; Humans ; Lymphatic Metastasis ; Mutation ; Observer Variation ; Proto-Oncogene Proteins B-raf/genetics ; Thyroid Cancer, Papillary/diagnosis ; Thyroid Cancer, Papillary/genetics ; Thyroid Cancer, Papillary/pathology ; Thyroid Gland/pathology ; Thyroid Neoplasms/diagnosis ; Thyroid Neoplasms/genetics ; Thyroid Neoplasms/pathology
Keywords
digital pathology ;  noninvasive follicular thyroid neoplasm with papillary-like nuclearfeatures ;  nuclear scoring system ; observer variation ; tumors of uncertain malignant potential
Abstract
To evaluate the current diagnostic criteria in reporting nuclear features of noninvasive follicularthyroid neoplasm with papillary-like nuclear features (NIFTP), nine Asian pathologists with expertise in thyroid reviewed virtual slides of 30 noninvasive follicular patterned thyroid lesions according to the nuclear scoring system originally proposed by an international expert and a more detailed scoring system proposed by the Asian Working Group. The interobserveragreement for nuclear grading score was generally moderate (kappa value = 0.452). The best consistency fell on the chromatin features (kappa value = 0.658-1.000). A fair to moderate interobserver agreement was demonstrated in the evaluation of nuclear elongation, nuclearoverlapping, membrane irregularities and distribution of papillary thyroid carcinoma (PTC) type nuclear features. A slight agreement was rendered for the evaluation of the nuclearenlargement. Intraobserver agreement was substantial to perfect when comparing results of both scoring systems. However, both scoring systems were not able to reliably separate NIFTP from an encapsulated follicular variant PTC with minimal lymph node metastasis or BRAFV600E mutation. Although the three-point nuclear scoring system for the diagnosis of NIFTP is widely used in Asian practice, interobserver variation was considerable. Ancillary immunohistochemical or molecular testing might be helpful in differentiating NIFTP from true PTC.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1111/pin.12779
DOI
10.1111/pin.12779
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Hong, Soon Won(홍순원) ORCID logo https://orcid.org/0000-0002-0324-2414
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170335
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