A Selective Biomarker Panel Increases the Reproducibility and the Accuracy in Endometrial Biopsy Diagnosis

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A Selective Biomarker Panel Increases the Reproducibility and the Accuracy in Endometrial Biopsy Diagnosis. / Nastic, Denis; Shanwell, Emma; Wallin, Keng-Ling; Valla, Marit; Måsbäck, Anna; Mateoiu, Claudia; Lidang, Marianne; Liakka, Annikki; Lappi-Blanco, Elisa; Grove, Anni; Davidson, Ben; Carpen, Olli; Bertelsen, Bjørn I.; Bak, Julia; Abusland, Anne B.; Selling, Jonas; Carlson, Joseph W.

In: International Journal of Gynecological Pathology, Vol. 36, No. 4, 2017, p. 339-347.

Research output: Contribution to journalArticle

Harvard

Nastic, D, Shanwell, E, Wallin, K-L, Valla, M, Måsbäck, A, Mateoiu, C, Lidang, M, Liakka, A, Lappi-Blanco, E, Grove, A, Davidson, B, Carpen, O, Bertelsen, BI, Bak, J, Abusland, AB, Selling, J & Carlson, JW 2017, 'A Selective Biomarker Panel Increases the Reproducibility and the Accuracy in Endometrial Biopsy Diagnosis', International Journal of Gynecological Pathology, vol. 36, no. 4, pp. 339-347. https://doi.org/10.1097/PGP.0000000000000334

APA

CBE

Nastic D, Shanwell E, Wallin K-L, Valla M, Måsbäck A, Mateoiu C, Lidang M, Liakka A, Lappi-Blanco E, Grove A, Davidson B, Carpen O, Bertelsen BI, Bak J, Abusland AB, Selling J, Carlson JW. 2017. A Selective Biomarker Panel Increases the Reproducibility and the Accuracy in Endometrial Biopsy Diagnosis. International Journal of Gynecological Pathology. 36(4):339-347. https://doi.org/10.1097/PGP.0000000000000334

MLA

Vancouver

Author

Nastic, Denis ; Shanwell, Emma ; Wallin, Keng-Ling ; Valla, Marit ; Måsbäck, Anna ; Mateoiu, Claudia ; Lidang, Marianne ; Liakka, Annikki ; Lappi-Blanco, Elisa ; Grove, Anni ; Davidson, Ben ; Carpen, Olli ; Bertelsen, Bjørn I. ; Bak, Julia ; Abusland, Anne B. ; Selling, Jonas ; Carlson, Joseph W. / A Selective Biomarker Panel Increases the Reproducibility and the Accuracy in Endometrial Biopsy Diagnosis. In: International Journal of Gynecological Pathology. 2017 ; Vol. 36, No. 4. pp. 339-347.

RIS

TY - JOUR

T1 - A Selective Biomarker Panel Increases the Reproducibility and the Accuracy in Endometrial Biopsy Diagnosis

AU - Nastic, Denis

AU - Shanwell, Emma

AU - Wallin, Keng-Ling

AU - Valla, Marit

AU - Måsbäck, Anna

AU - Mateoiu, Claudia

AU - Lidang, Marianne

AU - Liakka, Annikki

AU - Lappi-Blanco, Elisa

AU - Grove, Anni

AU - Davidson, Ben

AU - Carpen, Olli

AU - Bertelsen, Bjørn I.

AU - Bak, Julia

AU - Abusland, Anne B.

AU - Selling, Jonas

AU - Carlson, Joseph W.

PY - 2017

Y1 - 2017

N2 - Grading and histologic typing of endometrial cancer in biopsy material has a direct impact on the decision to perform lymphadenectomy and/or omentectomy in many cancer centers. Endometrial biopsies are among the most common general surgical pathology specimens. Multiple studies have shown that biopsy diagnosis suffers from a lack of reproducibility. Although many biomarkers have been proposed, none have been demonstrated to improve the diagnosis in the biopsy setting. In this study, 70 biopsies with endometrial carcinoma were supplemented with a biomarker panel consisting of ER, PR, P53, and DNA ploidy. A representative H&E slide was scanned digitally and made available to 12 gynecologic pathologists in 4 Nordic countries: Finland, Denmark, Sweden, and Norway. Reviewers diagnosed the cases both before and after being provided with the biomarker results. The interobserver percent agreement and Cohen κ improved from 75.8% (κ=0.52, moderate) to 84% (κ=0.68, substantial) with inclusion of the biomarker panel. Agreement with the subsequent hysterectomy diagnosis also improved from 83.6% (κ=0.67) to 88.7% (κ=0.77). There was no statistical improvement between a reflex (84% agreement) and a reflective testing algorithm (82.9% agreement), suggesting that the selective use of biomarkers is appropriate. Difficult cases were almost exclusively high-grade tumors. Finally, a statistical model indicated that only P53 and DNA ploidy, in conjunction with an H&E review, had an impact on the decision to upgrade or downgrade cases.

AB - Grading and histologic typing of endometrial cancer in biopsy material has a direct impact on the decision to perform lymphadenectomy and/or omentectomy in many cancer centers. Endometrial biopsies are among the most common general surgical pathology specimens. Multiple studies have shown that biopsy diagnosis suffers from a lack of reproducibility. Although many biomarkers have been proposed, none have been demonstrated to improve the diagnosis in the biopsy setting. In this study, 70 biopsies with endometrial carcinoma were supplemented with a biomarker panel consisting of ER, PR, P53, and DNA ploidy. A representative H&E slide was scanned digitally and made available to 12 gynecologic pathologists in 4 Nordic countries: Finland, Denmark, Sweden, and Norway. Reviewers diagnosed the cases both before and after being provided with the biomarker results. The interobserver percent agreement and Cohen κ improved from 75.8% (κ=0.52, moderate) to 84% (κ=0.68, substantial) with inclusion of the biomarker panel. Agreement with the subsequent hysterectomy diagnosis also improved from 83.6% (κ=0.67) to 88.7% (κ=0.77). There was no statistical improvement between a reflex (84% agreement) and a reflective testing algorithm (82.9% agreement), suggesting that the selective use of biomarkers is appropriate. Difficult cases were almost exclusively high-grade tumors. Finally, a statistical model indicated that only P53 and DNA ploidy, in conjunction with an H&E review, had an impact on the decision to upgrade or downgrade cases.

KW - biopsies

KW - biomarker

KW - endometri

UR - http://www.scopus.com/inward/record.url?scp=85014056286&partnerID=8YFLogxK

U2 - 10.1097/PGP.0000000000000334

DO - 10.1097/PGP.0000000000000334

M3 - Article

VL - 36

SP - 339

EP - 347

JO - International Journal of Gynecological Pathology

T2 - International Journal of Gynecological Pathology

JF - International Journal of Gynecological Pathology

SN - 0277-1691

IS - 4

ER -