A1 Refereed original research article in a scientific journal
Interobserver reproducibility of perineural invasion of prostatic adenocarcinoma in needle biopsies
Authors: Egevad Lars, Delahunt Brett, Samaratunga Hemamali, Tsuzuki Toyonori, Olsson Henrik, Ström Peter, Lindskog Cecilia, Häkkinen Tomi, Kartasalo Kimmo, Eklund Martin, Ruusuvuori Pekka
Publisher: SPRINGER
Publication year: 2021
Journal: Virchows Archiv
Journal name in source: VIRCHOWS ARCHIV
Journal acronym: VIRCHOWS ARCH
Volume: 478
First page : 1109
Last page: 1116
Number of pages: 8
ISSN: 0945-6317
eISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-021-03039-z
Web address : https://link.springer.com/article/10.1007/s00428-021-03039-z
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/53052304
Numerous studies have shown a correlation between perineural invasion (PNI) in prostate biopsies and outcome. The reporting of PNI varies widely in the literature. While the interobserver variability of prostate cancer grading has been studied extensively, less is known regarding the reproducibility of PNI. A total of 212 biopsy cores from a population-based screening trial were included in this study (106 with and 106 without PNI according to the original pathology reports). The glass slides were scanned and circulated among four pathologists with a special interest in urological pathology for assessment of PNI. Discordant cases were stained by immunohistochemistry for S-100 protein. PNI was diagnosed by all four observers in 34.0% of cases, while 41.5% were considered to be negative for PNI. In 24.5% of cases, there was a disagreement between the observers. The kappa for interobserver variability was 0.67-0.75 (mean 0.73). The observations from one participant were compared with data from the original reports, and a kappa for intraobserver variability of 0.87 was achieved. Based on immunohistochemical findings among discordant cases, 88.6% had PNI while 11.4% did not. The most common diagnostic pitfall was the presence of bundles of stroma or smooth muscle. It was noted in a few cases that collagenous micronodules could be mistaken for a nerve. The distance between cancer and nerve was another cause of disagreement. Although the results suggest that the reproducibility of PNI may be greater than that of prostate cancer grading, there is still a need for improvement and standardization.
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