WHO/ISUP grading of clear cell renal cell carcinoma and papillary renal cell carcinoma; validation of grading on the digital pathology platform and perspectives on reproducibility of grade

Background There are recognised potential pitfalls in digital diagnosis in urological pathology, including the grading of dysplasia. The World Health Organisation/International Society of Urological Pathology (WHO/ISUP) grading system for renal cell carcinoma (RCC) is prognostically important in cle...

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Veröffentlicht in:Diagnostic pathology Jg. 16; H. 1; S. 75 - 10
Hauptverfasser: Browning, Lisa, Colling, Richard, Verrill, Clare
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London BioMed Central 21.08.2021
BioMed Central Ltd
Springer Nature B.V
BMC
Schlagworte:
Biopsy
Carcinoma, Papillary - pathology
Carcinoma, Renal cell
Carcinoma, Renal Cell - pathology
Clear cell-type renal cell carcinoma
Databases, Factual
Digital imaging
Digital pathology
Dysplasia
Grading
Histology
Humans
ISUP
Kidney cancer
Kidney Neoplasms - pathology
Laboratories
Medicine
Medicine & Public Health
Microscopy
Neoplasm Grading
Observer Variation
Papillary renal cell carcinoma
Pathologists
Pathology
Predictive Value of Tests
Renal carcinoma
Reproducibility
Reproducibility of Results
Short Report
Validation
Validation studies
World health
Validation
Digital pathology
Grading
Reproducibility
Renal carcinoma
ISUP
ISSN:1746-1596, 1746-1596
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Zusammenfassung:Background There are recognised potential pitfalls in digital diagnosis in urological pathology, including the grading of dysplasia. The World Health Organisation/International Society of Urological Pathology (WHO/ISUP) grading system for renal cell carcinoma (RCC) is prognostically important in clear cell RCC (CCRCC) and papillary RCC (PRCC), and is included in risk stratification scores for CCRCC, thus impacting on patient management. To date there are no systematic studies examining the concordance of WHO/ISUP grading between digital pathology (DP) and glass slide (GS) images. We present a validation study examining intraobserver agreement in WHO/ISUP grade of CCRCC and PRCC. Methods Fifty CCRCCs and 10 PRCCs were graded (WHO/ISUP system) by three specialist uropathologists on three separate occasions (DP once then two GS assessments; GS1 and GS2) separated by wash-out periods of at least two-weeks. The grade was recorded for each assessment, and compared using Cohen’s and Fleiss’s kappa. Results There was 65 to 78% concordance of WHO/ISUP grading on DP and GS1. Furthermore, for the individual pathologists, the comparative kappa scores for DP versus GS1, and GS1 versus GS2, were 0.70 and 0.70, 0.57 and 0.73, and 0.71 and 0.74, and with no apparent tendency to upgrade or downgrade on DP versus GS. The interobserver kappa agreement was less, at 0.58 on DP and 0.45 on GS. Conclusion Our results demonstrate that the assessment of WHO/ISUP grade on DP is noninferior to that on GS. There is an apparent slight improvement in agreement between pathologists on RCC grade when assessed on DP, which may warrant further study.
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ISSN:1746-1596
1746-1596
DOI:10.1186/s13000-021-01130-2