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Interobserver Variability in the Assessment of Tumor Budding in pT 3/4 Colon Cancer: Improvement by Supporting Immunohistochemistry?

Authors
  • Martin, Benedikt1
  • Mayr, Patrick1, 2
  • Ihringer, Regina1
  • Schäfer, Eva-Maria1
  • Jakubowicz, Elżbieta1
  • Anthuber, Matthias
  • Schenkirsch, Gerhard
  • Schaller, Tina1
  • Märkl, Bruno1
  • 1 (B.M.)
  • 2 Department of Hematology and Clinical Oncology, University Medical Center Augsburg, 86156 Augsburg, Germany
Type
Published Article
Journal
Diagnostics
Publisher
MDPI
Publication Date
Sep 21, 2020
Volume
10
Issue
9
Identifiers
DOI: 10.3390/diagnostics10090730
PMID: 32967382
PMCID: PMC7555133
Source
PubMed Central
Keywords
License
Green

Abstract

The prognostic significance of tumor budding in colon cancer is unequivocally documented, and the recommendations of the International Tumor Budding Consensus Conference (ITBCC) are currently the accepted basis for its assessment. Up to now, it is unknown whether the general use of a supporting cytokeratin immunohistochemistry can improve the interobserver variability and prognostic significance. Six investigators with different levels of experience reassessed 229 cases of colon carcinoma (pT3/4, N+/−, M0) with a supporting cytokeratin immunohistochemistry. The results were compared to previous assessments, which have been performed only on H & E. Bd3 was significantly associated with the occurrence of distant metastases according to the assessments of three out of six investigators ( p < 0.05). Only one single investigator reached significant results concerning the cancer specific survival ( p = 0.01). The pairwise kappa values range between a poor and moderate level of agreement (range 0.17–0.45; median 0.21). In conclusion, the results show no superiority of the use of an additional cytokeratin immunohistochemistry compared to the conventional analysis on sole H & E slides. Therefore, the general supporting use of a cytokeratin immunohistochemical staining seems to be inadvisable in colon cancer in consideration of necessary resources and costs.

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