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p16 Improves interobserver agreement in diagnosis of anal intraepithelial neoplasia.

Publication ,  Journal Article
Bean, SM; Meara, RS; Vollmer, RT; Conner, MG; Crowe, DR; Novak, L; Eltoum, IA; Robboy, SJ; Chhieng, DC
Published in: J Low Genit Tract Dis
July 2009

OBJECTIVES: Evaluation of anal intraepithelial neoplasia (AIN) is subjective. Previous studies have shown p16 and Ki-67 expressions to correlate with AIN grade. Biomarkers like p16 and Ki-67 may improve interobserver agreement. The objectives were (1) to determine the extent of interobserver agreement in evaluating AIN on routine hematoxylin and eosin (H&E) sections and (2) to test whether p16 and/or Ki-67 staining improve interobserver diagnostic agreement. MATERIALS AND METHODS: Seventy-seven anal specimens were retrieved. Sections were stained with monoclonal antibodies against p16 and Ki-67. Blind to the original diagnoses, 4 pathologists assessed H&E alone, p16 alone, Ki-67 alone, and all 3 simultaneously. Diagnoses were normal/reactive, AIN I/HPV, AIN II, and AIN III. Agreement was calculated using kappa and S statistics. RESULTS: Pathologists were board certified and had 2 to 25 years (mean = 13.6 years) of experience. Fair agreement was observed using H&E diagnosis alone (kappa = 0.38, S = 0.56). The p16 diagnostic evaluation demonstrated the highest agreement (kappa = 0.57, S = 0.73). Interobserver agreement for Ki-67 alone and for H&E/p16/Ki-67 combined were comparable to that of H&E alone (kappa = 0.4, S = 0.54 and kappa = 0.44, S = 0.62, respectively). When the pathologists' diagnoses for all diagnostic evaluations were compared with consensus diagnoses, the lowest average magnitude of disagreement was seen with Ki-67 alone, followed by p16 alone, H&E/p16/Ki-67 combined, and H&E alone. CONCLUSIONS: Interobserver agreement for diagnosis of AIN was fair when based solely on H&E preparation. p16 alone improved interobserver agreement and demonstrated superior agreement when compared with H&E, Ki-67, and H&E/p16/Ki-67 combined.

Duke Scholars

Published In

J Low Genit Tract Dis

DOI

EISSN

1526-0976

Publication Date

July 2009

Volume

13

Issue

3

Start / End Page

145 / 153

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Obstetrics & Reproductive Medicine
  • Observer Variation
  • Middle Aged
  • Male
  • Humans
  • Genes, p16
  • Gene Expression Regulation, Neoplastic
  • Female
  • Diagnosis, Differential
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bean, S. M., Meara, R. S., Vollmer, R. T., Conner, M. G., Crowe, D. R., Novak, L., … Chhieng, D. C. (2009). p16 Improves interobserver agreement in diagnosis of anal intraepithelial neoplasia. J Low Genit Tract Dis, 13(3), 145–153. https://doi.org/10.1097/LGT.0b013e3181934486
Bean, Sarah M., Regina S. Meara, Robin T. Vollmer, Michael G. Conner, D Ralph Crowe, Lea Novak, Isam A. Eltoum, Stanley J. Robboy, and David C. Chhieng. “p16 Improves interobserver agreement in diagnosis of anal intraepithelial neoplasia.J Low Genit Tract Dis 13, no. 3 (July 2009): 145–53. https://doi.org/10.1097/LGT.0b013e3181934486.
Bean SM, Meara RS, Vollmer RT, Conner MG, Crowe DR, Novak L, et al. p16 Improves interobserver agreement in diagnosis of anal intraepithelial neoplasia. J Low Genit Tract Dis. 2009 Jul;13(3):145–53.
Bean, Sarah M., et al. “p16 Improves interobserver agreement in diagnosis of anal intraepithelial neoplasia.J Low Genit Tract Dis, vol. 13, no. 3, July 2009, pp. 145–53. Pubmed, doi:10.1097/LGT.0b013e3181934486.
Bean SM, Meara RS, Vollmer RT, Conner MG, Crowe DR, Novak L, Eltoum IA, Robboy SJ, Chhieng DC. p16 Improves interobserver agreement in diagnosis of anal intraepithelial neoplasia. J Low Genit Tract Dis. 2009 Jul;13(3):145–153.

Published In

J Low Genit Tract Dis

DOI

EISSN

1526-0976

Publication Date

July 2009

Volume

13

Issue

3

Start / End Page

145 / 153

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Obstetrics & Reproductive Medicine
  • Observer Variation
  • Middle Aged
  • Male
  • Humans
  • Genes, p16
  • Gene Expression Regulation, Neoplastic
  • Female
  • Diagnosis, Differential