Akademik Veri Yönetim Sistemi
37th European Congress of Pathology, Vienna, Avusturya, 6 - 10 Eylül 2025, cilt.487, ss.188, (Özet Bildiri)
Background & Objectives: Invasive non-mucinous lung adenocarcinomas are classified by predominant histologic subtype, though multiple patterns often coexist. Subtyping and the evaluation of spread through air spaces (STAS) are clinically relevant for grading and prognosis, but both can be challenging. This study evaluates interobserver agreement in subtyping and STAS assessment among pathologists with varying experience and specialization.
Methods: An online survey was conducted using selected static digital images from resected non-mucinous lung adenocarcinoma cases diagnosed at our institution. Fifty-seven pathologists participated, each evaluating two different cases. For each case, they estimated the proportion of five histologic subtypes using predefined percentage ranges. STAS assessment was based on two representative images per case, with responses recorded as present, absent, or not sure. Interobserver agreement was assessed using the intraclass correlation coefficient (ICC) for subtype scoring and Fleiss’ kappa for STAS. Participants were categorized into three groups based on experience: thoracic pathology specialists, pathologists with more than five years of experience, and those with less than five years.
Results: The overall ICC for subtype scoring was 0.77, indicating good agreement. Some subtypes could not be statistically evaluated due to minimal score variation, suggesting strong concordance. Frequency analysis showed consistent scoring for acinar and lepidic patterns. In contrast, papillary and micropapillary patterns—especially in Case 2—exhibited broader distributions. Fleiss’ kappa for STAS was 0.48. Scoring patterns varied by experience, with specialists showing more consistency.
Conclusion: Despite overall agreement, interpretive variability in certain subtypes and STAS highlights the need for improved standardization and training, especially for diagnostically ambiguous features. The influence of experience and specialization on scoring consistency supports the value of targeted education and consensus development. Standardized criteria may improve reproducibility and diagnostic confidence, contributing to more consistent clinical decision-making in pulmonary pathology