Impact of immunohistochemical markers, CK5/6 and E-cadherin on diagnostic agreement in non-invasive proliferative breast lesions
Impact of immunohistochemical markers, CK5/6 and E-cadherin on diagnostic agreement in non-invasive proliferative breast lesions
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DOI：
10.1111/j.1365-2559.2008.03016.x
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发表时间：
2008-05-01
期刊：
影响因子：
6.4
通讯作者：
Mathoulin-Pelissier, S.
中科院分区：
文献类型：
--
作者：
MacGrogan, G.;Arnould, L.;Mathoulin-Pelissier, S.
目的：评估细胞角蛋白（CK）5/6和E-钙粘蛋白免疫组化对非侵袭性增生性乳腺病变的诊断协议的影响。方法和结果：20名病理学家将105例非侵袭性增生性乳腺病变分为10个诊断类别。在第一轮分析每个病例的一个苏木精和伊红（H&E）载玻片，在第二轮分析具有相应CK 5/6和E-钙粘蛋白免疫组织化学的一个H&E载玻片。在每一轮中测量观察者间对类别特异性和管理特异性病变的再现性。CK 5/6和E-cadherin对诊断一致性的影响很小，在第一轮和第二轮之间保持中等水平（总体kappa系数分别为0.47和0.53，P = NS）。具有特异性CK 5/6和E-cadherin免疫特征的病变（普通导管增生、不典型导管增生、不典型小叶增生、小叶原位癌、非高级别导管原位癌）的一致性水平略有改善，但观察到的差异无统计学意义。然而，诊断一致性改善时，病变根据其管理类别（整体kappa系数为0.58和0.66，在第一轮和第二轮，分别）。结论：CK 5/6和E-钙粘蛋白免疫组化对观察者间的非侵入性乳腺病变的重现性影响不大。然而，诊断一致性可以通过将病变分组到管理类别中来提高。
Aims: To assess the impact of cytokeratin (CK) 5/6 and E-cadherin immunohistochemistry on diagnostic agreement of non-invasive proliferative breast lesions.Methods and results: Twenty pathologists classified 105 cases of non-invasive proliferative breast lesions into 10 diagnostic categories. One haematoxylin and eosin (H&E) slide of each case was analysed on a first round and one H&E slide with corresponding CK5/6 and E-cadherin immunohistochemistry was analysed on a second round. Interobserver reproducibility for category-specific and management-specific lesions was measured on each round. CK5/6 and E-cadherin had little impact on diagnostic agreement, which remained moderate between the first and second rounds (overall kappa coefficients of 0.47 and 0.53, respectively, P = NS). Levels of agreement slightly improved for lesions with specific CK5/6 and E-cadherin immunoprofiles (usual ductal hyperplasia, atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, non-high-grade ductal carcinoma in situ), but the differences observed were not statistically significant. However, diagnostic agreement improved when lesions were grouped according to their management category (overall kappa coefficients of 0.58 and 0.66 in the first and second rounds, respectively).Conclusions: CK5/6 and E-cadherin immunohistochemistry has little impact on interobserver reproducibility for non-invasive breast lesions. Diagnostic agreement can, however, be improved by grouping lesions in management categories.