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Interobserver variation in the classification of thymic tumours--a multicentre study using the WHO classification system |
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| Authors: | Verghese E T den Bakker M A Campbell A Hussein A Nicholson A G Rice A Corrin B Rassl D Langman G Monaghan H Gosney J Seet J Kerr K Suvarna S K Burke M Bishop P Pomplun S Willemsen S Addis B |
| Affiliation: | Department of Pathology, Leeds Teaching Hospital NHS Trust, Leeds, UK;, Departments of Pathology;and Epidemiology &BioStatistics, Erasmus MC, The Netherlands;, Department of Pathology, Hull Royal Infirmary, Hull, UK;, Department of Pathology and Cytology, SU/Sahlgrenska, Sweden;, Department of Pathology, Royal Brompton Hospital, Royal Brompton &Harefield NHS Trust;, Department of Pathology, Imperial College Healthcare NHS Trust;and Department of Pathology, Imperial College, London;, Department of Pathology, Papworth Hospital NHS Foundation Trust, Cambridge;, Department of Pathology, Birmingham Heartlands Hospital, Birmingham;, Department of Pathology, Royal Infirmary of Edinburgh, Edinburgh;, Department of Pathology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool;, Department of Pathology, St George's Healthcare Trust, London;, Department of Pathology, Aberdeen Royal Infirmary, Aberdeen;, Department of Pathology, Northern General Hospital, Sheffield;, Department of Pathology, Harefield Hospital, Royal Brompton &Harefield NHS Trust, London;, Department of Pathology, University Hospital of South Manchester Foundation Hospital NHS Trust, Manchester;, Department of Pathology, King's College Hospital NHS Foundation Trust, London;, and Department of Pathology, Southampton University Hospitals NHS Trust, Southampton, UK |
| Abstract: | Aims: To test the reproducibility of the current World Health Organization (WHO) classification of thymic epithelial tumours and to determine the level of interobserver variation within a group of pathologists, all with experience and expertise in thoracic pathology. Methods and results: Ninety-five thymic tumours were circulated to a group of 17 pathologists in the UK and The Netherlands over a 1-year period. Participants were asked to classify them according to WHO criteria. The diagnoses were subjected to statistical analysis and κ values calculated. The overall level of agreement was moderate (κ 0.45). When the categories were reduced in number by creating two groups, (A + AB + B1 + B2 and B3 + C), the level of agreement increased to 0.62. An alternative grouping (A + AB + B1 and B2 + B3 + C) increased it slightly further. The best agreement was in tumour types A and AB. Difficulties arose in distinguishing B1 tumours from B2 tumours and B2 tumours from B3 tumours. Conclusions: Although the WHO system describes a number of well-defined tumour types with clear diagnostic criteria, the overall level of agreement was moderate and improved if some groups were amalgamated. |
| Keywords: | interobserver agreement kappa thymic carcinoma thymoma WHO classification |
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