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. 1995 Sep;48(9):856–860. doi: 10.1136/jcp.48.9.856

Malignant mesothelioma of the pleura: interobserver variability.

A Andrion 1, C Magnani 1, P G Betta 1, A Donna 1, F Mollo 1, M Scelsi 1, P Bernardi 1, M Botta 1, B Terracini 1
PMCID: PMC502876  PMID: 7490321

Abstract

AIMS--To assess the consistency of histopathological diagnosis of pleural malignant mesothelioma by estimating interobserver agreement between five pathologists. METHODS--Eighty eight histological sets pertaining to original diagnoses of pleural malignant mesothelioma were reviewed separately by each pathologist. Diagnostic likelihood was graded as definite (A), probable (B), possible (C), improbable (D), and definitely not (E) malignant mesothelioma. The following indexes were estimated: observed proportion of agreement (Po), kappa statistics and proportion of agreement for "positive" (Ppos) and "negative" (Pneg) diagnoses. RESULTS--Sixty cases (68.2%) were rated by at least three reviewers as A or B and by none of the others as D or E. Five (5.7%) were rated by at least two reviewers as D or E and by none of the others as A or B. Nine (10.2%) showed a serious disagreement, rated A or B and D or E. Agreement for sets obtained at necropsy/surgery (median kappa w = 0.57) was similar to that for endoscopic material (median kappa w = 0.54). Agreement was poor on material obtained by needle biopsy (median kappa w = 0.21). The median value of Ppos varied between 0.94 (necropsy/surgery) and 0.67 (needle biopsy) and that of Pneg between 0.78 (necropsy/surgery) and 0.34 (unspecified biopsy). Interobserver agreement on histological typing was good overall (median kappa = 0.59). CONCLUSIONS--Of the original histological diagnoses, 70% were consistently reproduced through panel review. Most indexes of agreement between pathologists ranged from poor (needle biopsy) to moderate (necropsy/surgery). Agreement in confirming malignant mesothelioma was greater than that regarding exclusion of this diagnosis. Of the cases finally considered to have malignant mesothelioma, the reproducibility of histological typing was relatively satisfactory.

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Selected References

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  1. Boutin C., Rey F., Gouvernet J., Viallat J. R., Astoul P., Ledoray V. Thoracoscopy in pleural malignant mesothelioma: a prospective study of 188 consecutive patients. Part 2: Prognosis and staging. Cancer. 1993 Jul 15;72(2):394–404. doi: 10.1002/1097-0142(19930715)72:2<394::aid-cncr2820720214>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
  2. Brennan P., Silman A. Statistical methods for assessing observer variability in clinical measures. BMJ. 1992 Jun 6;304(6840):1491–1494. doi: 10.1136/bmj.304.6840.1491. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Burnett R. A., Swanson Beck J., Howatson S. R., Lee F. D., Lessells A. M., McLaren K. M., Ogston S., Robertson A. J., Simpson J. G., Smith G. D. Observer variability in histopathological reporting of malignant bronchial biopsy specimens. J Clin Pathol. 1994 Aug;47(8):711–713. doi: 10.1136/jcp.47.8.711. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Campobasso O., Andrion A., Ribotta M., Ronco G. The value of the 1981 WHO histological classification in inter-observer reproducibility and changing pattern of lung cancer. Int J Cancer. 1993 Jan 21;53(2):205–208. doi: 10.1002/ijc.2910530205. [DOI] [PubMed] [Google Scholar]
  5. Cicchetti D. V. Assessing inter-rater reliability for rating scales: resolving some basic issues. Br J Psychiatry. 1976 Nov;129:452–456. doi: 10.1192/bjp.129.5.452. [DOI] [PubMed] [Google Scholar]
  6. Cicchetti D. V., Feinstein A. R. High agreement but low kappa: II. Resolving the paradoxes. J Clin Epidemiol. 1990;43(6):551–558. doi: 10.1016/0895-4356(90)90159-m. [DOI] [PubMed] [Google Scholar]
  7. Dini S., Santucci M., Biancalani M., Pingitore R., Lopane P., Tosi P., Megha T., Sforza V. Pleural malignant mesothelioma in Tuscany, Italy (1970-1988): I. Anatomo-pathologic aspects. Am J Ind Med. 1992;21(4):569–576. doi: 10.1002/ajim.4700210412. [DOI] [PubMed] [Google Scholar]
  8. Donna A., Betta P. G. Mesodermomas: a new embryological approach to primary tumours of coelomic surfaces. Histopathology. 1981 Jan;5(1):31–44. doi: 10.1111/j.1365-2559.1981.tb01764.x. [DOI] [PubMed] [Google Scholar]
  9. Feinstein A. R., Cicchetti D. V. High agreement but low kappa: I. The problems of two paradoxes. J Clin Epidemiol. 1990;43(6):543–549. doi: 10.1016/0895-4356(90)90158-l. [DOI] [PubMed] [Google Scholar]
  10. Fraire A. E., Cooper S., Greenberg S. D., Buffler P., Langston C. Mesothelioma of childhood. Cancer. 1988 Aug 15;62(4):838–847. doi: 10.1002/1097-0142(19880815)62:4<838::aid-cncr2820620433>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
  11. Freedman L. S., Machin D. Pathology review in cancer research. Br J Cancer. 1993 Nov;68(5):827–830. doi: 10.1038/bjc.1993.440. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hartmann C. A., Schütze H. Mesothelioma-like tumors of the pleura: a review of 72 autopsy cases. J Cancer Res Clin Oncol. 1994;120(6):331–347. doi: 10.1007/BF01247458. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hillerdal G. Malignant mesothelioma 1982: review of 4710 published cases. Br J Dis Chest. 1983 Oct;77(4):321–343. [PubMed] [Google Scholar]
  14. Magnani C., Terracini B., Ivaldi C., Botta M., Mancini A., Andrion A. Pleural malignant mesothelioma and non-occupational exposure to asbestos in Casale Monferrato, Italy. Occup Environ Med. 1995 Jun;52(6):362–367. doi: 10.1136/oem.52.6.362. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. McCaughey W. T., Al-Jabi M., Kannerstein M. A Canadian experience of the pathological diagnosis of diffuse mesothelioma. IARC Sci Publ. 1980;(30):207–210. [PubMed] [Google Scholar]
  16. McCaughey W. T., Colby T. V., Battifora H., Churg A., Corson J. M., Greenberg S. D., Grimes M. M., Hammar S., Roggli V. L., Unni K. K. Diagnosis of diffuse malignant mesothelioma: experience of a US/Canadian Mesothelioma Panel. Mod Pathol. 1991 May;4(3):342–353. [PubMed] [Google Scholar]
  17. McDonald A. D., Magner D., Eyssen G. Primary malignant mesothelial tumors in Canada, 1960-1968. A pathologic review by the Mesothelioma Panel of the Canadian Tumor Reference Centre. Cancer. 1973 Apr;31(4):869–876. doi: 10.1002/1097-0142(197304)31:4<869::aid-cncr2820310416>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]
  18. Skov B. G., Lauritzen A. F., Hirsch F., Nielsen H. W. The histopathological diagnosis of malignant mesothelioma v. pulmonary adenocarcinoma: reproducibility of the histopathological diagnosis. Histopathology. 1994 Jun;24(6):553–557. doi: 10.1111/j.1365-2559.1994.tb00575.x. [DOI] [PubMed] [Google Scholar]
  19. Svanholm H., Starklint H., Barlebo H., Olsen S. Histological evaluation of prostatic cancer. 1. Reproducibility of tumour type. APMIS. 1989 Aug;97(8):699–704. doi: 10.1111/j.1699-0463.1989.tb00465.x. [DOI] [PubMed] [Google Scholar]
  20. Vobecky J., Leduc C. P., Devroede G., Madarnas P. The reliability of routine pathologic diagnosis of colorectal adenocarcinoma. Cancer. 1989 Sep 15;64(6):1261–1265. doi: 10.1002/1097-0142(19890915)64:6<1261::aid-cncr2820640616>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  21. Weiss L. M., Battifora H. The search for the optimal immunohistochemical panel for the diagnosis of malignant mesothelioma. Hum Pathol. 1993 Apr;24(4):345–346. doi: 10.1016/0046-8177(93)90079-v. [DOI] [PubMed] [Google Scholar]
  22. van Gelder T., Hoogsteden H. C., Vandenbroucke J. P., van der Kwast T. H., Planteydt H. T. The influence of the diagnostic technique on the histopathological diagnosis in malignant mesothelioma. Virchows Arch A Pathol Anat Histopathol. 1991;418(4):315–317. doi: 10.1007/BF01600160. [DOI] [PubMed] [Google Scholar]

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