alexa Reproducibility and validation of tumour stroma ratio scoring on oesophageal adenocarcinoma biopsies.
Pathology

Pathology

Journal of Medical & Surgical Pathology

Author(s): Courrech Staal EF, Smit VT, van Velthuysen ML, SpitzerNaaykens JM, Wouters MW,

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Abstract BACKGROUND: Tumour stroma ratio (TSR) in histological sections of resected oesophageal adenocarcinomas proved to be a prognostic factor for patients' survival. The objectives of this study were to assess inter- and intraobserver agreement for TSR scoring on biopsy material and to validate these biopsy results with the results derived from surgical specimens. METHODS: Biopsies and surgical specimens of 91 patients with oesophageal adenocarcinoma were available. TSR was determined on the original haematoxylin-eosin (H&E) tissue sections from primary tumour biopsies. To assess interobserver variation, TSR was scored by three pathologists as 0-25\%, 25-50\%, 50-75\% or 75-100\%. A second scoring was done to examine intraobserver variation. The definitive TSR biopsy score was compared with the corresponding resection specimen score. Kappa statistics were applied to evaluate agreement. RESULTS: Biopsies of 10 (11\%) patients were rejected because of poor quality. For 81 TSR biopsy scores, interobserver correlations ranged between 0.239 and 0.486 (P < 0.001 for all). By classifying scores into two groups (<50\% and ≥ 50\%), interobserver correlations ranged between 0.372 and 0.886 (P < 0.001 for all). Intraobserver agreement was substantial to near-perfect (κ = 0.780-0.848; P < 0.001 for all). Definitive TSR biopsy score showed moderate correlation with TSR scores on surgical specimens (κ = 0.506), but it was an independent prognostic factor for survival. CONCLUSION: Reproducibility of tumour stroma ratio scoring on oesophageal adenocarcinoma biopsies was good. The ease of TSR scoring on H&E sections together with its correlation with patients' survival may have clinical relevance in this era of neoadjuvant therapy. Copyright © 2010 Elsevier Ltd. All rights reserved. This article was published in Eur J Cancer and referenced in Journal of Medical & Surgical Pathology

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