Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Downes, MR; Lajkosz, K; Algaba, F; Allory, Y; Amin, MB; Cheng, L; Desai, S; Eckstein, M; Hartmann, A; Lopez-Beltran, A; Mannweiler, S; van Montfoort, ML; Oxley, J; Paner, GP; Samaratunga, H; Shen, S; Warrick, J; Williamson, SR; Wobker, SE; van der Kwast, TH.
Interobserver reproducibility of a hybrid three-tier grading system of papillary nonmuscle invasive urothelial carcinoma: an international Uropathology study
HISTOPATHOLOGY. 2025;
Doi: 10.1111/his.15438
Web of Science
PubMed
FullText
FullText_MUG
- Co-authors Med Uni Graz
- Mannweiler Sebastian
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- Aims A hybrid-three tier system with low grade (LG), high grade- G2 (HG-G2), high grade- G3 (HG-G3) has been proposed in recognition of, and to help address, the clinical heterogeneity within high grade WHO 2004/2022. We assessed interobserver reproducibility amongst international uropathologists using this three-tier approach. Methods and Results Papillary Ta nonmuscle invasive bladder cancer (NMIBC) specimens (n = 30) were selected and graded by two uropathologists and assessed using WHO 2004/2022 and WHO 1973 and categorized as LG (n = 15), HG-G2 (n = 8), HG-G3 (n = 7), and photographed at 10x and 20x magnification. Images were circulated via Survey Monkey to invited uropathologists who determined: (1) that image was LG or HG, and (2) if HG, assigned to G2 or G3. Model-based kappa measure of association was used to assess interrater agreement. Eighteen uropathologists:(eight North American, eight European, two other) assessed 60 images with 1076 gradings for analysis. The kappa value amongst Europeans versus North Americans was 0.663 versus 0.647 for 10x images and 0.682 versus 0.623 for 20x images. At 10x, agreement for LG, HG-G2, and HG-G3 was 74.6%, 63.6%, and 92.0%, and at 20x was 64.3%, 63.9%, and 95.2% respectively. Conclusion Three-tier grading of papillary Ta NMIBC had substantial interobserver agreement amongst international uropathologists. The recognition of the HG-G3 case reached the highest concordance. North American uropathologists had comparable kappa scores (substantial agreement) to Europeans, despite being unaccustomed to separating HG cases into G2 and G3, demonstrating three-tier grading could be "quickly" adopted by genitourinary experts if endorsed and required by the relevant bodies in their jurisdiction of practice.
- Find related publications in this database (Keywords)
- bladder cancer
- hybrid grading
- interobserver variation
- nonmuscle invasive
- papillary