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Problems in grading of prostatic carcinoma: interobserver reproducibility of five different grading systems

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Summary

In order to investigate the reproducibility of grading systems for prostatic carcinoma currently in use, a comparative histological grading study was done. These studies were carried out on tissue sections from radical prostatectomy specimens (N=50) stained with hematoxylin and eosin. Five pathologists with varying professional experience participated in the study, using five different grading systems: those of Broders, Brawn, Gleason (for statistical compilation the modified version), Mostofi, and a modified Mostofi grading method recently described by Schroeder and Mostofi. Weighted kappa coefficients ranged from 0.21 to 0.52. None of the systems investigated demonstrated a high degree of reproducibility (k>0.70). Reproducibility of the systems described by Broders and Brawn was reasonably good (k=0.52 and 0.41, respectively). With the modified Gleason method (rearrangement of Gleason scores into 3 grades), a considerable difference was noted between the numerical agreement score (among at least 3 observers) and the measured kappa value (100% and 0.30, respectively). The methods described by Mostofi and Schroeder-Mostofi revealed only limited reproducibility (k=0.21 and 0.34, respectively).

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Authors and Affiliations

  1. Department of Pathology, Erasmus University, NL-3000 DR, Rotterdam, The Netherlands

    Fiebo J. W. ten Kate, Maarten P. W. Gallee, Roy O. van der Heul & M. Eric F. Prins

  2. Department of Biostatistics, Erasmus University, NL-3000 DR, Rotterdam, The Netherlands

    Paul I. M. Schmitz

  3. Department of Urology, Erasmus University, NL-3000 DR, Rotterdam, The Netherlands

    Jan H. M. Blom

  4. Department of Pathology, Bergweg Hospital, NL-3000 DR, Rotterdam, The Netherlands

    Adriaan C. Joebsis

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  1. Fiebo J. W. ten Kate
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  2. Maarten P. W. Gallee
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  3. Paul I. M. Schmitz
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  4. Adriaan C. Joebsis
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  5. Roy O. van der Heul
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  6. M. Eric F. Prins
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  7. Jan H. M. Blom
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ten Kate, F.J.W., Gallee, M.P.W., Schmitz, P.I.M. et al. Problems in grading of prostatic carcinoma: interobserver reproducibility of five different grading systems. World J Urol 4, 147–152 (1986). https://doi.org/10.1007/BF00327011

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  • DOI: https://doi.org/10.1007/BF00327011

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