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Concordance of the histological diagnosis of type 1 autoimmune pancreatitis and its distinction from pancreatic ductal adenocarcinoma with endoscopic ultrasound-guided fine needle biopsy specimens: an interobserver agreement study.
Notohara, Kenji; Kamisawa, Terumi; Furukawa, Toru; Fukushima, Noriyoshi; Uehara, Takeshi; Kasashima, Satomi; Iwasaki, Eisuke; Kanno, Atsushi; Kawashima, Atsuhiro; Kubota, Kensuke; Kuraishi, Yasuhiro; Motoya, Masayo; Naitoh, Itaru; Nishino, Takayoshi; Sakagami, Junichi; Shimizu, Kyoko; Tomono, Teruko; Aishima, Shinichi; Fukumura, Yuki; Hirabayashi, Kenichi; Kojima, Motohiro; Mitsuhashi, Tomoko; Naito, Yoshiki; Ohike, Nobuyuki; Tajiri, Takuma; Yamaguchi, Hiroshi; Fujiwara, Hideyo; Ibuki, Emi; Kobayashi, Shota; Miyaoka, Masashi; Nagase, Mamiko; Nakashima, Junko; Nakayama, Masamichi; Oda, Shinsuke; Taniyama, Daiki; Tsuyama, Sho; Watanabe, Syunsuke; Ikeura, Tsukasa; Kawa, Shigeyuki; Okazaki, Kazuichi.
Afiliación
  • Notohara K; Department of Anatomic Pathology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan. notohara@kchnet.or.jp.
  • Kamisawa T; Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
  • Furukawa T; Department of Investigative Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Fukushima N; Department of Pathology, Jichi Medical University, Shimotsuke, Japan.
  • Uehara T; Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
  • Kasashima S; Department of Clinical Laboratory Science, Graduate School of Health Science, Kanazawa University, Kanazawa, Japan.
  • Iwasaki E; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
  • Kanno A; Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Kawashima A; Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan.
  • Kubota K; Department of Diagnostic Pathology, National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan.
  • Kuraishi Y; Depatment of Endoscopy, Yokohama City University Hospital, Yokohama, Japan.
  • Motoya M; Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan.
  • Naitoh I; Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan.
  • Nishino T; Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
  • Sakagami J; Department of Gastroenterology, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo, Japan.
  • Shimizu K; Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Tomono T; Fukuchiyama City Hospital, Fukuchiyama, Japan.
  • Aishima S; Department of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
  • Fukumura Y; Department of Gastroenterology, Kyoto University Hospital, Kyoto, Japan.
  • Hirabayashi K; Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga, Japan.
  • Kojima M; Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan.
  • Mitsuhashi T; Department of Pathology, Tokai University School of Medicine, Isehara, Japan.
  • Naito Y; Division of Pathology, Research Center for Innovative Oncology, National Cancer Center, Kashiwa, Japan.
  • Ohike N; Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan.
  • Tajiri T; Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan.
  • Yamaguchi H; Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Japan.
  • Fujiwara H; Division of Pathology, Shizuoka Cancer Center, Sunto-gun, Japan.
  • Ibuki E; Department of Diagnostic Pathology, Tokai University Hachioji Hospital, Hachioji, Japan.
  • Kobayashi S; Department of Pathology, Saitama Medical University, Saitama, Japan.
  • Miyaoka M; Department of Pathology, Kawasaki Medical School, Kurashiki, Japan.
  • Nagase M; Department of Diagnostic Pathology, Kagawa University, Kita-gun, Japan.
  • Nakashima J; Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
  • Nakayama M; Department of Pathology, Tokai University School of Medicine, Isehara, Japan.
  • Oda S; Department of Organ Pathology, Faculty of Medicine, Shimane University, Izumo, Japan.
  • Taniyama D; Department of Pathology, Kochi Medical School, Kochi University, Nangoku, Japan.
  • Tsuyama S; Department of Pathology, Kurume University School of Medicine, Kurume, Japan.
  • Watanabe S; Department of Diagnostic Pathology, Tottori Prefectural Central Hospital, Tottori, Japan.
  • Ikeura T; Molecular Pathology, Hiroshima University, Hiroshima, Japan.
  • Kawa S; Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan.
  • Okazaki K; Tokushima Red Cross Hospital, Tokushima, Japan.
Virchows Arch ; 480(3): 565-575, 2022 Mar.
Article en En | MEDLINE | ID: mdl-34820715
The histological diagnosis of type 1 autoimmune pancreatitis (AIP) based on the findings obtained by an endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) is feasible, but the diagnostic consistency of this method has not been confirmed. We determined the interobserver agreement among 20 pathologists regarding the diagnosis of type 1 AIP, including the distinction from pancreatic ductal adenocarcinoma (PDAC) using large tissue samples obtained by EUS-FNB. After guidance for diagnosing AIP with biopsy tissues was provided, a round 2 was performed. The median sensitivity and specificity for diagnosing PDAC vs. non-neoplastic diseases were 95.2% and 100%, respectively. In groups of specialists (n = 7) and the generalists (n = 13), Fleiss' к-values increased from 0.886 to 0.958 and from 0.750 to 0.816 in round 2. The concordance was fair or moderate for obliterative phlebitis and storiform fibrosis but slight for ductal lesion of type 1 AIP. Discordant results were due to ambiguous findings and biopsy tissue limitations. Among the specialists, the ratio of cases with perfect agreement regarding the presence of storiform fibrosis increased in round 2, but agreement regarding obliterative phlebitis or ductal lesions was not improved. Although the histological definite diagnosis of type 1 AIP was achieved by most observers in > 60% of the cases, the confidence levels varied. Because some ambiguities exist, the histological diagnostic levels based on the diagnostic criteria of type 1 AIP should not be taken for granted. Guidance is effective for improving accurate PDAC diagnoses (notably by recognizing acinar-ductal metaplasia) and for evaluating storiform fibrosis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Pancreáticas / Flebitis / Enfermedades Autoinmunes / Carcinoma Ductal Pancreático / Pancreatitis Autoinmune Tipo de estudio: Diagnostic_studies / Guideline Límite: Humans Idioma: En Revista: Virchows Arch Asunto de la revista: BIOLOGIA MOLECULAR / PATOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Pancreáticas / Flebitis / Enfermedades Autoinmunes / Carcinoma Ductal Pancreático / Pancreatitis Autoinmune Tipo de estudio: Diagnostic_studies / Guideline Límite: Humans Idioma: En Revista: Virchows Arch Asunto de la revista: BIOLOGIA MOLECULAR / PATOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Alemania