Cytokeratin immunohistochemistry improves interobserver variability between unskilled pathologists in the evaluation of tumor budding in T1 colorectal cancer

Keita Kai, Shinichi Aishima, Shigehisa Aoki, Yukari Takase, Kazuyoshi Uchihashi, Masanori Masuda, Aki Nishijima-Matsunobu, Mihoko Yamamoto, Kousuke Ide, Atsushi Nakayama, Makiko Yamasaki, Shuji Toda

Research output: Contribution to journalArticlepeer-review

45 Citations (Scopus)

Abstract

Tumor budding is a major risk factor for T1 colorectal cancer. Quality control of the pathological diagnosis of budding is crucial, irrespective of the pathologist's experience. This study examines the interobserver variability according to pathologists' experience and evaluates the influence of cytokeratin (CK) immunostaining in the assessment of budding. Hematoxylin-eosin (HE) and CK-immunostained slides of 40 cases with T1 primary colorectal cancer were examined. Budding grades were individually evaluated by 12 pathologists who we categorized into three groups by their experience (expert, with >10 years of experience (n = 4), senior, with 5-10 years (n = 4), and junior, < 5 years (n = 4)). The results revealed a tendency for the more experienced pathologists to assign higher budding grades compared to the less-experienced pathologists. In the junior group, the interobserver variability obtained with HE slides was poor, but it was markedly improved in the evaluation using CK-immunostained slides. The benefit of CK immunostaining was only slight in the expert group. CK immunostaining would be useful when a pathologist is not experienced enough or does not have enough confidence in the assessment of budding.

Original languageEnglish
Pages (from-to)75-82
Number of pages8
JournalPathology International
Volume66
Issue number2
DOIs
Publication statusPublished - 01-02-2016
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

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