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Interobserver variability in the evaluation of mismatch repair protein immunostaining

Klarskov, Louise; Ladelund, Steen; Holck, Susanne; Roenlund, Karina; Lindebjerg, Jan; Elebro, Jacob LU ; Halvarsson, Britta; von Salome, Jenny; Bernstein, Inge and Nilbert, Mef LU (2010) In Human Pathology 41(10). p.1387-1396
Abstract
Immunohistochemical staining for mismatch repair proteins has during recent years been established as a routine analysis in many pathology laboratories with the aim to identify tumors linked to the hereditary nonpolyposis colorectal cancer syndrome. Despite widespread application, data on reliability are lacking. We therefore evaluated interobserver variability among 6 pathologists, 3 experienced gastrointestinal pathologists and 3 residents. In total, 225 immunohistochemically stained colorectal cancers were evaluated as having normal, weak, loss of, or nonevaluable mismatch repair protein staining. Full consensus was achieved in 51% of the stainings for MLH1, 61% for PMS2, 83% for MSH2, and 45% for MSH6. Weak stainings were the main... (More)
Immunohistochemical staining for mismatch repair proteins has during recent years been established as a routine analysis in many pathology laboratories with the aim to identify tumors linked to the hereditary nonpolyposis colorectal cancer syndrome. Despite widespread application, data on reliability are lacking. We therefore evaluated interobserver variability among 6 pathologists, 3 experienced gastrointestinal pathologists and 3 residents. In total, 225 immunohistochemically stained colorectal cancers were evaluated as having normal, weak, loss of, or nonevaluable mismatch repair protein staining. Full consensus was achieved in 51% of the stainings for MLH1, 61% for PMS2, 83% for MSH2, and 45% for MSH6. Weak stainings were the main cause of reduced consensus, whereas contradictory evaluations with normal as well as loss of staining were reported in 2% to 6% of the tumors. Interobserver variability was considerable, though experienced pathologists and residents reached the same level of consensus. Because results from immunohistochemical mismatch repair protein stainings are used for decisions on mutation analysis and as an aid in the interpretation of gene variants of unknown significance in hereditary nonpolyposis colorectal cancer, the interobserver variability identified highlights the need for quality assessment programs, including guidelines for classification of different expression patterns. (C) 2010 Elsevier Inc. All rights reserved. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
HNPCC, Immunohistochemistry, MMR, Reliability, Lynch Syndrome
in
Human Pathology
volume
41
issue
10
pages
1387 - 1396
publisher
Elsevier
external identifiers
  • wos:000282498600004
  • scopus:77957146724
ISSN
1532-8392
DOI
10.1016/j.humpath.2010.03.003
language
English
LU publication?
yes
id
b5089c0a-911a-43fe-8c27-5cf10e20b195 (old id 1727153)
date added to LUP
2010-12-01 13:23:45
date last changed
2018-05-29 11:06:51
@article{b5089c0a-911a-43fe-8c27-5cf10e20b195,
  abstract     = {Immunohistochemical staining for mismatch repair proteins has during recent years been established as a routine analysis in many pathology laboratories with the aim to identify tumors linked to the hereditary nonpolyposis colorectal cancer syndrome. Despite widespread application, data on reliability are lacking. We therefore evaluated interobserver variability among 6 pathologists, 3 experienced gastrointestinal pathologists and 3 residents. In total, 225 immunohistochemically stained colorectal cancers were evaluated as having normal, weak, loss of, or nonevaluable mismatch repair protein staining. Full consensus was achieved in 51% of the stainings for MLH1, 61% for PMS2, 83% for MSH2, and 45% for MSH6. Weak stainings were the main cause of reduced consensus, whereas contradictory evaluations with normal as well as loss of staining were reported in 2% to 6% of the tumors. Interobserver variability was considerable, though experienced pathologists and residents reached the same level of consensus. Because results from immunohistochemical mismatch repair protein stainings are used for decisions on mutation analysis and as an aid in the interpretation of gene variants of unknown significance in hereditary nonpolyposis colorectal cancer, the interobserver variability identified highlights the need for quality assessment programs, including guidelines for classification of different expression patterns. (C) 2010 Elsevier Inc. All rights reserved.},
  author       = {Klarskov, Louise and Ladelund, Steen and Holck, Susanne and Roenlund, Karina and Lindebjerg, Jan and Elebro, Jacob and Halvarsson, Britta and von Salome, Jenny and Bernstein, Inge and Nilbert, Mef},
  issn         = {1532-8392},
  keyword      = {HNPCC,Immunohistochemistry,MMR,Reliability,Lynch Syndrome},
  language     = {eng},
  number       = {10},
  pages        = {1387--1396},
  publisher    = {Elsevier},
  series       = {Human Pathology},
  title        = {Interobserver variability in the evaluation of mismatch repair protein immunostaining},
  url          = {http://dx.doi.org/10.1016/j.humpath.2010.03.003},
  volume       = {41},
  year         = {2010},
}