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  • Title: Determining the inter- and intraobserver reproducibility of the diagnosis of endometrial hyperplasia subgroups and well-differentiated endometrioid carcinoma in endometrial curettage specimens.
    Author: Izadi-Mood N, Khaniki M, Irvanloo G, Ahmadi SA, Hayeri H, Meysamie A.
    Journal: Arch Iran Med; 2009 Jul; 12(4):377-82. PubMed ID: 19566355.
    Abstract:
    BACKGROUND: Many studies have attempted to identify histologic features that help to distinguish atypical hyperplasia from hyperplasia without atypia and well-differentiated endometrioid carcinoma of the endometrium; however, few have evaluated the reproducibility of these diagnoses. METHODS: Five pathologists independently reviewed 100 endometrial curettage specimens chosen to represent the spectrum of proliferative lesions of the endometrium. This included simple hyperplasia, complex hyperplasia, atypical hyperplasia, and well-differentiated endometrioid carcinoma. Slides were reviewed once for interobserver agreement among the five pathologists and twice for intraobserver agreement by one of them. RESULTS: The results were assessed using the weighted kappa statistic. The mean intraobserver kappa value was 0.86. The mean interobserver kappa values by diagnostic category were as follows: simple hyperplasia without atypia: 0.74; complex hyperplasia without atypia: 0.33; atypical hyperplasia: 0.34, and well-differentiated endometrioid carcinoma: 0.64; with a kappa value of 0.53 for all cases combined. CONCLUSION: A major interobserver discrepancy exists in the diagnosis of complex and atypical hyperplasia which are the most similar mimics of endometrioid carcinoma.
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