Cargando…
Reproducibility and Feasibility of Classification and National Guidelines for Histological Diagnosis of Canine Mammary Gland Tumours: A Multi-Institutional Ring Study
SIMPLE SUMMARY: Tumours of the mammary gland are common in humans, as in canine species. They are very heterogenous with numerous morphological variants and different biologic behaviours. In the last few decades, several efforts have been made to classify these tumours histologically and establish t...
Autores principales: | , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9325225/ https://www.ncbi.nlm.nih.gov/pubmed/35878374 http://dx.doi.org/10.3390/vetsci9070357 |
_version_ | 1784756996755423232 |
---|---|
author | Papparella, Serenella Crescio, Maria Ines Baldassarre, Valeria Brunetti, Barbara Burrai, Giovanni P. Cocumelli, Cristiano Grieco, Valeria Iussich, Selina Maniscalco, Lorella Mariotti, Francesca Millanta, Francesca Paciello, Orlando Rasotto, Roberta Romanucci, Mariarita Sfacteria, Alessandra Zappulli, Valentina |
author_facet | Papparella, Serenella Crescio, Maria Ines Baldassarre, Valeria Brunetti, Barbara Burrai, Giovanni P. Cocumelli, Cristiano Grieco, Valeria Iussich, Selina Maniscalco, Lorella Mariotti, Francesca Millanta, Francesca Paciello, Orlando Rasotto, Roberta Romanucci, Mariarita Sfacteria, Alessandra Zappulli, Valentina |
author_sort | Papparella, Serenella |
collection | PubMed |
description | SIMPLE SUMMARY: Tumours of the mammary gland are common in humans, as in canine species. They are very heterogenous with numerous morphological variants and different biologic behaviours. In the last few decades, several efforts have been made to classify these tumours histologically and establish the level of malignancy by using histologic grading systems. However, reproducibility and diagnostic agreement of such classification and grading have been only rarely assessed. In this study, we tested the variability in diagnoses performed by 15 pathologists using the same classification and grading system. Prior to the study, pathologists agreed on guidelines regarding how to apply these systems. Pathologists worked blindly on 36 digital histologic slides of canine mammary tumours. The agreement was statistically analysed using Cohen’s kappa coefficient that, when equal to 1, indicates perfect agreement. The overall agreement in the identification of hyperplastic-dysplastic/benign/malignant lesions was substantial (kappa 0.76), while outcomes on morphological classification had only a moderate agreement (k = 0.54). Tumour grade assigned by pathologists was the least concordant and kappa could not be calculated. Although promising, the results underline that each diagnostic/grading system should be assessed and optimized for standardization and high diagnostic agreement. ABSTRACT: Histological diagnosis of Canine Mammary Tumours (CMTs) provides the basis for proper treatment and follow-up. Nowadays, its accuracy is poorly understood and variable interpretation of histological criteria leads to a lack of standardisation and impossibility to compare studies. This study aimed to quantify the reproducibility of histological diagnosis and grading in CMTs. A blinded ring test on 36 CMTs was performed by 15 veterinary pathologists with different levels of education, after discussion of critical points on the Davis-Thompson Foundation Classification and providing consensus guidelines. Kappa statistics were used to compare the interobserver variability. The overall concordance rate of diagnostic interpretations of WP on identification of hyperplasia-dysplasia/benign/malignant lesions showed a substantial agreement (average k ranging from 0.66 to 0.82, with a k-combined of 0.76). Instead, outcomes on ICD-O-3.2 morphological code /diagnosis of histotype had only a moderate agreement (average k ranging from 0.44 and 0.64, with a k-combined of 0.54). The results demonstrated that standardised classification and consensus guidelines can produce moderate to substantial agreement; however, further efforts are needed to increase this agreement in distinguishing benign versus malignant lesions and in histological grading. |
format | Online Article Text |
id | pubmed-9325225 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-93252252022-07-27 Reproducibility and Feasibility of Classification and National Guidelines for Histological Diagnosis of Canine Mammary Gland Tumours: A Multi-Institutional Ring Study Papparella, Serenella Crescio, Maria Ines Baldassarre, Valeria Brunetti, Barbara Burrai, Giovanni P. Cocumelli, Cristiano Grieco, Valeria Iussich, Selina Maniscalco, Lorella Mariotti, Francesca Millanta, Francesca Paciello, Orlando Rasotto, Roberta Romanucci, Mariarita Sfacteria, Alessandra Zappulli, Valentina Vet Sci Article SIMPLE SUMMARY: Tumours of the mammary gland are common in humans, as in canine species. They are very heterogenous with numerous morphological variants and different biologic behaviours. In the last few decades, several efforts have been made to classify these tumours histologically and establish the level of malignancy by using histologic grading systems. However, reproducibility and diagnostic agreement of such classification and grading have been only rarely assessed. In this study, we tested the variability in diagnoses performed by 15 pathologists using the same classification and grading system. Prior to the study, pathologists agreed on guidelines regarding how to apply these systems. Pathologists worked blindly on 36 digital histologic slides of canine mammary tumours. The agreement was statistically analysed using Cohen’s kappa coefficient that, when equal to 1, indicates perfect agreement. The overall agreement in the identification of hyperplastic-dysplastic/benign/malignant lesions was substantial (kappa 0.76), while outcomes on morphological classification had only a moderate agreement (k = 0.54). Tumour grade assigned by pathologists was the least concordant and kappa could not be calculated. Although promising, the results underline that each diagnostic/grading system should be assessed and optimized for standardization and high diagnostic agreement. ABSTRACT: Histological diagnosis of Canine Mammary Tumours (CMTs) provides the basis for proper treatment and follow-up. Nowadays, its accuracy is poorly understood and variable interpretation of histological criteria leads to a lack of standardisation and impossibility to compare studies. This study aimed to quantify the reproducibility of histological diagnosis and grading in CMTs. A blinded ring test on 36 CMTs was performed by 15 veterinary pathologists with different levels of education, after discussion of critical points on the Davis-Thompson Foundation Classification and providing consensus guidelines. Kappa statistics were used to compare the interobserver variability. The overall concordance rate of diagnostic interpretations of WP on identification of hyperplasia-dysplasia/benign/malignant lesions showed a substantial agreement (average k ranging from 0.66 to 0.82, with a k-combined of 0.76). Instead, outcomes on ICD-O-3.2 morphological code /diagnosis of histotype had only a moderate agreement (average k ranging from 0.44 and 0.64, with a k-combined of 0.54). The results demonstrated that standardised classification and consensus guidelines can produce moderate to substantial agreement; however, further efforts are needed to increase this agreement in distinguishing benign versus malignant lesions and in histological grading. MDPI 2022-07-13 /pmc/articles/PMC9325225/ /pubmed/35878374 http://dx.doi.org/10.3390/vetsci9070357 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Papparella, Serenella Crescio, Maria Ines Baldassarre, Valeria Brunetti, Barbara Burrai, Giovanni P. Cocumelli, Cristiano Grieco, Valeria Iussich, Selina Maniscalco, Lorella Mariotti, Francesca Millanta, Francesca Paciello, Orlando Rasotto, Roberta Romanucci, Mariarita Sfacteria, Alessandra Zappulli, Valentina Reproducibility and Feasibility of Classification and National Guidelines for Histological Diagnosis of Canine Mammary Gland Tumours: A Multi-Institutional Ring Study |
title | Reproducibility and Feasibility of Classification and National Guidelines for Histological Diagnosis of Canine Mammary Gland Tumours: A Multi-Institutional Ring Study |
title_full | Reproducibility and Feasibility of Classification and National Guidelines for Histological Diagnosis of Canine Mammary Gland Tumours: A Multi-Institutional Ring Study |
title_fullStr | Reproducibility and Feasibility of Classification and National Guidelines for Histological Diagnosis of Canine Mammary Gland Tumours: A Multi-Institutional Ring Study |
title_full_unstemmed | Reproducibility and Feasibility of Classification and National Guidelines for Histological Diagnosis of Canine Mammary Gland Tumours: A Multi-Institutional Ring Study |
title_short | Reproducibility and Feasibility of Classification and National Guidelines for Histological Diagnosis of Canine Mammary Gland Tumours: A Multi-Institutional Ring Study |
title_sort | reproducibility and feasibility of classification and national guidelines for histological diagnosis of canine mammary gland tumours: a multi-institutional ring study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9325225/ https://www.ncbi.nlm.nih.gov/pubmed/35878374 http://dx.doi.org/10.3390/vetsci9070357 |
work_keys_str_mv | AT papparellaserenella reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT cresciomariaines reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT baldassarrevaleria reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT brunettibarbara reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT burraigiovannip reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT cocumellicristiano reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT griecovaleria reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT iussichselina reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT maniscalcolorella reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT mariottifrancesca reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT millantafrancesca reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT pacielloorlando reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT rasottoroberta reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT romanuccimariarita reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT sfacteriaalessandra reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy AT zappullivalentina reproducibilityandfeasibilityofclassificationandnationalguidelinesforhistologicaldiagnosisofcaninemammaryglandtumoursamultiinstitutionalringstudy |