Participating investigators and centres are listed at the end of this study.
Grading of dysplasia in Barrett's oesophagus: substantial interobserver variation between general and gastrointestinal pathologists
Article first published online: 31 MAY 2007
Volume 50, Issue 7, pages 920–927, June 2007
How to Cite
Kerkhof, M., Van Dekken, H., Steyerberg, E. W., Meijer, G. A., Mulder, A. H., De Bruïne, A., Driessen, A., Ten Kate, F. J., Kusters, J. G., Kuipers, E. J., Siersema, P. D. and for the CYBAR study group (2007), Grading of dysplasia in Barrett's oesophagus: substantial interobserver variation between general and gastrointestinal pathologists. Histopathology, 50: 920–927. doi: 10.1111/j.1365-2559.2007.02706.x
- Issue published online: 31 MAY 2007
- Article first published online: 31 MAY 2007
- Date of submission 2 August 2006 Accepted for publication 22 October 2006
- Barrett's oesophagus;
- interobserver variation;
Aims: To determine interobserver variation in grading of dysplasia in Barrett's oesophagus (BO) between non-expert general pathologists and expert gastrointestinal pathologists on the one hand and between expert pathologists on the other hand.
Methods and results: In this prospective multicentre study, non-expert and expert pathologists graded biopsy specimens of 920 patients with endoscopic BO, which were blindly reviewed by one member of a panel of expert pathologists (panel experts) and by a second panel expert in case of disagreement on dysplasia grade. Agreement between two of three pathologists was established as the final diagnosis. Analysis was performed by κ statistics. Due to absence of intestinal metaplasia, 127/920 (14%) patients were excluded. The interobserver agreement for dysplasia [no dysplasia (ND) versus indefinite for dysplasia/low-grade dysplasia (IND/LGD) versus high-grade dysplasia (HGD)/adenocarcinoma (AC)] between non-experts and first panel experts and between initial experts and first panel experts was fair (κ = 0.24 and κ = 0.27, respectively), and substantial for differentiation of HGD/AC from ND/IND/LGD (κ = 0.62 and κ = 0.58, respectively).
Conclusions: There was considerable interobserver variability in the interpretation of ND or IND/LGD in BO between non-experts and experts, but also between expert pathologists. This suggests that less subjective markers are needed to determine the risk of developing AC in BO.