The Ueno method for substaging pT1 colorectal adenocarcinoma by depth and width measurement: an interobserver study

Aim Early pT1 polyp colorectal cancers (CRCs) present challenges for accurate pathology substaging. Haggitt and Kikuchi stages depend on polyp morphology and are often difficult to apply due to suboptimal orientation or fragmentation, or absence of the muscularis propria in polypectomy or submucosal...

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Veröffentlicht in:Colorectal disease 2015-08, Vol.17 (8), p.674-681
Hauptverfasser: Wang, L. M., Guy, R., Fryer, E., Kartsonaki, C., Gill, P., Hughes, C., Szuts, A., Perera, R., Chetty, R., Mortensen, N.
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container_end_page 681
container_issue 8
container_start_page 674
container_title Colorectal disease
container_volume 17
creator Wang, L. M.
Guy, R.
Fryer, E.
Kartsonaki, C.
Gill, P.
Hughes, C.
Szuts, A.
Perera, R.
Chetty, R.
Mortensen, N.
description Aim Early pT1 polyp colorectal cancers (CRCs) present challenges for accurate pathology substaging. Haggitt and Kikuchi stages depend on polyp morphology and are often difficult to apply due to suboptimal orientation or fragmentation, or absence of the muscularis propria in polypectomy or submucosal resection specimens. European guidelines for quality assurance suggest using Ueno's more objective approach, using depth and width measurements beyond muscularis mucosae. We have investigated interobserver variation using Ueno's approach. Method Ten consecutive pT1 polyp CRCs were identified and the slides assessed by six gastrointestinal pathologists for depth and width of invasion. A further 60 polyps were studied by a group of specialist and general pathologists. Agreement was assessed by analysis of variance. A polyp CRC is classified as high risk if it has a depth ≥ 2000 μm or a width ≥ 4000 μm and low risk with a depth
doi_str_mv 10.1111/codi.12910
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M. ; Guy, R. ; Fryer, E. ; Kartsonaki, C. ; Gill, P. ; Hughes, C. ; Szuts, A. ; Perera, R. ; Chetty, R. ; Mortensen, N.</creator><creatorcontrib>Wang, L. M. ; Guy, R. ; Fryer, E. ; Kartsonaki, C. ; Gill, P. ; Hughes, C. ; Szuts, A. ; Perera, R. ; Chetty, R. ; Mortensen, N.</creatorcontrib><description>Aim Early pT1 polyp colorectal cancers (CRCs) present challenges for accurate pathology substaging. Haggitt and Kikuchi stages depend on polyp morphology and are often difficult to apply due to suboptimal orientation or fragmentation, or absence of the muscularis propria in polypectomy or submucosal resection specimens. European guidelines for quality assurance suggest using Ueno's more objective approach, using depth and width measurements beyond muscularis mucosae. We have investigated interobserver variation using Ueno's approach. Method Ten consecutive pT1 polyp CRCs were identified and the slides assessed by six gastrointestinal pathologists for depth and width of invasion. A further 60 polyps were studied by a group of specialist and general pathologists. Agreement was assessed by analysis of variance. A polyp CRC is classified as high risk if it has a depth ≥ 2000 μm or a width ≥ 4000 μm and low risk with a depth &lt; 2000 μm or a width &lt; 4000 μm. Concordance for the dichotomized values was assessed using the kappa statistic. Results The intraclass correlation coefficient (ICC) for depth was 0.83 and for width 0.56 in the 10‐polyp group. The ICC for the 60‐polyp CRCs was 0.67 for depth and 0.37 for width. In both groups, when polyp CRCs are divided into high‐ and low‐risk categories based on depth, there was substantial and moderate agreement (κ = 0.80 and 0.47) but only fair agreement when based on width (κ = 0.34 and 0.35). Conclusion Ueno's method has the advantage of being independent of polyp morphology. Our study shows better concordance for depth measurement and reproducibility in nonfragmented specimens, with poorer agreement when based on width.</description><identifier>ISSN: 1462-8910</identifier><identifier>EISSN: 1463-1318</identifier><identifier>DOI: 10.1111/codi.12910</identifier><identifier>PMID: 25620664</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adenocarcinoma - pathology ; Colonic Polyps - pathology ; Colorectal Neoplasms - pathology ; depth and width measurement ; Humans ; Malignant colorectal polyp ; Neoplasm Staging - methods ; Observer Variation ; polyp pT1 colorectal cancer ; Reproducibility of Results ; Tumor Burden</subject><ispartof>Colorectal disease, 2015-08, Vol.17 (8), p.674-681</ispartof><rights>Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland</rights><rights>Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4330-4a1e003697203138b5866c0d7ba33fbb8df854ce777f126a20a268efcbc0594b3</citedby><cites>FETCH-LOGICAL-c4330-4a1e003697203138b5866c0d7ba33fbb8df854ce777f126a20a268efcbc0594b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fcodi.12910$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fcodi.12910$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25620664$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, L. M.</creatorcontrib><creatorcontrib>Guy, R.</creatorcontrib><creatorcontrib>Fryer, E.</creatorcontrib><creatorcontrib>Kartsonaki, C.</creatorcontrib><creatorcontrib>Gill, P.</creatorcontrib><creatorcontrib>Hughes, C.</creatorcontrib><creatorcontrib>Szuts, A.</creatorcontrib><creatorcontrib>Perera, R.</creatorcontrib><creatorcontrib>Chetty, R.</creatorcontrib><creatorcontrib>Mortensen, N.</creatorcontrib><title>The Ueno method for substaging pT1 colorectal adenocarcinoma by depth and width measurement: an interobserver study</title><title>Colorectal disease</title><addtitle>Colorectal Dis</addtitle><description>Aim Early pT1 polyp colorectal cancers (CRCs) present challenges for accurate pathology substaging. Haggitt and Kikuchi stages depend on polyp morphology and are often difficult to apply due to suboptimal orientation or fragmentation, or absence of the muscularis propria in polypectomy or submucosal resection specimens. European guidelines for quality assurance suggest using Ueno's more objective approach, using depth and width measurements beyond muscularis mucosae. We have investigated interobserver variation using Ueno's approach. Method Ten consecutive pT1 polyp CRCs were identified and the slides assessed by six gastrointestinal pathologists for depth and width of invasion. A further 60 polyps were studied by a group of specialist and general pathologists. Agreement was assessed by analysis of variance. A polyp CRC is classified as high risk if it has a depth ≥ 2000 μm or a width ≥ 4000 μm and low risk with a depth &lt; 2000 μm or a width &lt; 4000 μm. Concordance for the dichotomized values was assessed using the kappa statistic. Results The intraclass correlation coefficient (ICC) for depth was 0.83 and for width 0.56 in the 10‐polyp group. The ICC for the 60‐polyp CRCs was 0.67 for depth and 0.37 for width. In both groups, when polyp CRCs are divided into high‐ and low‐risk categories based on depth, there was substantial and moderate agreement (κ = 0.80 and 0.47) but only fair agreement when based on width (κ = 0.34 and 0.35). Conclusion Ueno's method has the advantage of being independent of polyp morphology. Our study shows better concordance for depth measurement and reproducibility in nonfragmented specimens, with poorer agreement when based on width.</description><subject>Adenocarcinoma - pathology</subject><subject>Colonic Polyps - pathology</subject><subject>Colorectal Neoplasms - pathology</subject><subject>depth and width measurement</subject><subject>Humans</subject><subject>Malignant colorectal polyp</subject><subject>Neoplasm Staging - methods</subject><subject>Observer Variation</subject><subject>polyp pT1 colorectal cancer</subject><subject>Reproducibility of Results</subject><subject>Tumor Burden</subject><issn>1462-8910</issn><issn>1463-1318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1P3DAQhq2Kqny0l_6AykdUKdSOHTvprVraLSoCVVrUo-WPCWtI4q3tlO6_x7DAkbnM6NUzz-FF6CMlJ7TMFxucP6F1R8kbdEC5YBVltN17vOuqLfk-OkzphhAqJG3fof26ETURgh-gtFoDvoIp4BHyOjjch4jTbFLW1366xpsVxTYMIYLNesDaFdTqaP0URo3NFjvY5DXWk8N33pVrBJ3mCCNM-WuJsZ8yxGASxH9QzHl22_foba-HBB-e9hG6-vF9tfhZnV8uzxbfzivLGSMV1xQIYaKTNWGUtaZphbDESaMZ641pXd823IKUsqe10DXRtWiht8aSpuOGHaHjnXcTw98ZUlajTxaGQU8Q5qSobBjnvGOyoJ93qI0hpQi92kQ_6rhVlKiHktVDyeqx5AJ_evLOZgT3gj63WgC6A-78ANtXVGpxeXr2LK12Pz5l-P_yo-OtEpLJRv25WKrFsvvF2OlvRdk9JtWXCw</recordid><startdate>201508</startdate><enddate>201508</enddate><creator>Wang, L. M.</creator><creator>Guy, R.</creator><creator>Fryer, E.</creator><creator>Kartsonaki, C.</creator><creator>Gill, P.</creator><creator>Hughes, C.</creator><creator>Szuts, A.</creator><creator>Perera, R.</creator><creator>Chetty, R.</creator><creator>Mortensen, N.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201508</creationdate><title>The Ueno method for substaging pT1 colorectal adenocarcinoma by depth and width measurement: an interobserver study</title><author>Wang, L. M. ; Guy, R. ; Fryer, E. ; Kartsonaki, C. ; Gill, P. ; Hughes, C. ; Szuts, A. ; Perera, R. ; Chetty, R. ; Mortensen, N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4330-4a1e003697203138b5866c0d7ba33fbb8df854ce777f126a20a268efcbc0594b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adenocarcinoma - pathology</topic><topic>Colonic Polyps - pathology</topic><topic>Colorectal Neoplasms - pathology</topic><topic>depth and width measurement</topic><topic>Humans</topic><topic>Malignant colorectal polyp</topic><topic>Neoplasm Staging - methods</topic><topic>Observer Variation</topic><topic>polyp pT1 colorectal cancer</topic><topic>Reproducibility of Results</topic><topic>Tumor Burden</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, L. M.</creatorcontrib><creatorcontrib>Guy, R.</creatorcontrib><creatorcontrib>Fryer, E.</creatorcontrib><creatorcontrib>Kartsonaki, C.</creatorcontrib><creatorcontrib>Gill, P.</creatorcontrib><creatorcontrib>Hughes, C.</creatorcontrib><creatorcontrib>Szuts, A.</creatorcontrib><creatorcontrib>Perera, R.</creatorcontrib><creatorcontrib>Chetty, R.</creatorcontrib><creatorcontrib>Mortensen, N.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, L. M.</au><au>Guy, R.</au><au>Fryer, E.</au><au>Kartsonaki, C.</au><au>Gill, P.</au><au>Hughes, C.</au><au>Szuts, A.</au><au>Perera, R.</au><au>Chetty, R.</au><au>Mortensen, N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Ueno method for substaging pT1 colorectal adenocarcinoma by depth and width measurement: an interobserver study</atitle><jtitle>Colorectal disease</jtitle><addtitle>Colorectal Dis</addtitle><date>2015-08</date><risdate>2015</risdate><volume>17</volume><issue>8</issue><spage>674</spage><epage>681</epage><pages>674-681</pages><issn>1462-8910</issn><eissn>1463-1318</eissn><abstract>Aim Early pT1 polyp colorectal cancers (CRCs) present challenges for accurate pathology substaging. Haggitt and Kikuchi stages depend on polyp morphology and are often difficult to apply due to suboptimal orientation or fragmentation, or absence of the muscularis propria in polypectomy or submucosal resection specimens. European guidelines for quality assurance suggest using Ueno's more objective approach, using depth and width measurements beyond muscularis mucosae. We have investigated interobserver variation using Ueno's approach. Method Ten consecutive pT1 polyp CRCs were identified and the slides assessed by six gastrointestinal pathologists for depth and width of invasion. A further 60 polyps were studied by a group of specialist and general pathologists. Agreement was assessed by analysis of variance. A polyp CRC is classified as high risk if it has a depth ≥ 2000 μm or a width ≥ 4000 μm and low risk with a depth &lt; 2000 μm or a width &lt; 4000 μm. Concordance for the dichotomized values was assessed using the kappa statistic. Results The intraclass correlation coefficient (ICC) for depth was 0.83 and for width 0.56 in the 10‐polyp group. The ICC for the 60‐polyp CRCs was 0.67 for depth and 0.37 for width. In both groups, when polyp CRCs are divided into high‐ and low‐risk categories based on depth, there was substantial and moderate agreement (κ = 0.80 and 0.47) but only fair agreement when based on width (κ = 0.34 and 0.35). Conclusion Ueno's method has the advantage of being independent of polyp morphology. Our study shows better concordance for depth measurement and reproducibility in nonfragmented specimens, with poorer agreement when based on width.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>25620664</pmid><doi>10.1111/codi.12910</doi><tpages>8</tpages></addata></record>
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subjects Adenocarcinoma - pathology
Colonic Polyps - pathology
Colorectal Neoplasms - pathology
depth and width measurement
Humans
Malignant colorectal polyp
Neoplasm Staging - methods
Observer Variation
polyp pT1 colorectal cancer
Reproducibility of Results
Tumor Burden
title The Ueno method for substaging pT1 colorectal adenocarcinoma by depth and width measurement: an interobserver study
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