Improved diagnostic stratification of digitised Barrett's oesophagus biopsies by p53 immunohistochemical staining

Myrtle J van der Wel; Lucas C Duits; Roos E Pouw; Cornelis A Seldenrijk; G J A Offerhaus; Mike Visser; Fiebo J Ten Kate; Katharina Biermann; Lodewijk A A Brosens; Michael Doukas; Clement Huysentruyt; Arend Karrenbeld; Gursah Kats-Ugurlu; Jaap S van der Laan; G Ineke van Lijnschoten; Freek C P Moll; Ariadne H A G Ooms; Hans van der Valk; Jan G Tijssen; Jacques J Bergman; Sybren L Meijer

doi:https://doi.org/10.1111/his.13462

Improved diagnostic stratification of digitised Barrett's oesophagus biopsies by p53 immunohistochemical staining

Myrtle J van der Wel, Lucas C Duits, Roos E Pouw, Cornelis A Seldenrijk, G J A Offerhaus, Mike Visser, Fiebo J Ten Kate, Katharina Biermann, Lodewijk A A Brosens, Michael Doukas, Clement Huysentruyt, Arend Karrenbeld, Gursah Kats-Ugurlu, Jaap S van der Laan, G Ineke van Lijnschoten, Freek C P Moll, Ariadne H A G Ooms, Hans van der Valk, Jan G Tijssen, Jacques J BergmanSybren L Meijer

Research output: Contribution to journal › Article › Academic › peer-review

27 Citations (Scopus)

Abstract

AIMS: Interobserver agreement for dysplasia in Barrett's oesophagus (BO) is low, and guidelines advise expert review of dysplastic cases. The aim of this study was to assess the added value of p53 immunohistochemistry (IHC) for the homogeneity within a group of dedicated gastrointestinal (GI) pathologists.

METHODS AND RESULTS: Sixty-single haematoxylin and eosin (HE) slide referral BO cases [20 low-grade dysplasia (LGD); 20 high-grade dysplasia (HGD); and 20 non-dysplastic BO reference cases] were digitalised and independently assessed twice in random order by 10 dedicated GI pathologists. After a 'wash-out' period, cases were reassessed with the addition of a corresponding p53 IHC slide. Outcomes were: (i) proportion of 'indefinite for dysplasia' (IND) diagnoses; (ii) interobserver agreement; and (iii) diagnostic accuracy as compared with a consensus 'gold standard' diagnosis defined at an earlier stage by five core expert BO pathologists after their assessment of this case set. Addition of p53 IHC decreased the mean proportion of IND diagnoses from 10 of 60 to eight of 60 (P = 0.071). Mean interobserver agreement increased significantly from 0.45 to 0.57 (P = 0.0021). The mean diagnostic accuracy increased significantly from 72% to 82% (P = 0.0072) after p53 IHC addition.

CONCLUSION: Addition of p53 IHC significantly improves the histological assessment of BO biopsies, even within a group of dedicated GI pathologists. It decreases the proportion of IND diagnoses, and increases interobserver agreement and diagnostic accuracy. This justifies the use of accessory p53 IHC within our upcoming national digital review panel for BO biopsy cases.

Original language	English
Pages (from-to)	1015-1023
Number of pages	9
Journal	Histopathology
Volume	72
Issue number	6
Early online date	2018
DOIs	https://doi.org/10.1111/his.13462
Publication status	Published - May 2018

Keywords

Barrett Esophagus/diagnosis
Biomarkers/analysis
Biopsy
Humans
Image Interpretation, Computer-Assisted/methods
Immunohistochemistry
Observer Variation
Tumor Suppressor Protein p53/analysis

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https://doi.org/10.1111/his.13462

Cite this

van der Wel, M. J., Duits, L. C., Pouw, R. E., Seldenrijk, C. A., Offerhaus, G. J. A., Visser, M., Ten Kate, F. J., Biermann, K., Brosens, L. A. A., Doukas, M., Huysentruyt, C., Karrenbeld, A., Kats-Ugurlu, G., van der Laan, J. S., van Lijnschoten, G. I., Moll, F. C. P., Ooms, A. H. A. G., van der Valk, H., Tijssen, J. G., ... Meijer, S. L. (2018). Improved diagnostic stratification of digitised Barrett's oesophagus biopsies by p53 immunohistochemical staining. Histopathology, 72(6), 1015-1023. https://doi.org/10.1111/his.13462

@article{372b9042ab7041db807a09b103c1a21c,

title = "Improved diagnostic stratification of digitised Barrett's oesophagus biopsies by p53 immunohistochemical staining",

abstract = "AIMS: Interobserver agreement for dysplasia in Barrett's oesophagus (BO) is low, and guidelines advise expert review of dysplastic cases. The aim of this study was to assess the added value of p53 immunohistochemistry (IHC) for the homogeneity within a group of dedicated gastrointestinal (GI) pathologists.METHODS AND RESULTS: Sixty-single haematoxylin and eosin (HE) slide referral BO cases [20 low-grade dysplasia (LGD); 20 high-grade dysplasia (HGD); and 20 non-dysplastic BO reference cases] were digitalised and independently assessed twice in random order by 10 dedicated GI pathologists. After a 'wash-out' period, cases were reassessed with the addition of a corresponding p53 IHC slide. Outcomes were: (i) proportion of 'indefinite for dysplasia' (IND) diagnoses; (ii) interobserver agreement; and (iii) diagnostic accuracy as compared with a consensus 'gold standard' diagnosis defined at an earlier stage by five core expert BO pathologists after their assessment of this case set. Addition of p53 IHC decreased the mean proportion of IND diagnoses from 10 of 60 to eight of 60 (P = 0.071). Mean interobserver agreement increased significantly from 0.45 to 0.57 (P = 0.0021). The mean diagnostic accuracy increased significantly from 72% to 82% (P = 0.0072) after p53 IHC addition.CONCLUSION: Addition of p53 IHC significantly improves the histological assessment of BO biopsies, even within a group of dedicated GI pathologists. It decreases the proportion of IND diagnoses, and increases interobserver agreement and diagnostic accuracy. This justifies the use of accessory p53 IHC within our upcoming national digital review panel for BO biopsy cases.",

keywords = "Barrett Esophagus/diagnosis, Biomarkers/analysis, Biopsy, Humans, Image Interpretation, Computer-Assisted/methods, Immunohistochemistry, Observer Variation, Tumor Suppressor Protein p53/analysis",

author = "{van der Wel}, {Myrtle J} and Duits, {Lucas C} and Pouw, {Roos E} and Seldenrijk, {Cornelis A} and Offerhaus, {G J A} and Mike Visser and {Ten Kate}, {Fiebo J} and Katharina Biermann and Brosens, {Lodewijk A A} and Michael Doukas and Clement Huysentruyt and Arend Karrenbeld and Gursah Kats-Ugurlu and {van der Laan}, {Jaap S} and {van Lijnschoten}, {G Ineke} and Moll, {Freek C P} and Ooms, {Ariadne H A G} and {van der Valk}, Hans and Tijssen, {Jan G} and Bergman, {Jacques J} and Meijer, {Sybren L}",

note = "{\textcopyright} 2018 John Wiley & Sons Ltd.",

year = "2018",

month = may,

doi = "https://doi.org/10.1111/his.13462",

language = "English",

volume = "72",

pages = "1015--1023",

journal = "Histopathology",

issn = "0309-0167",

publisher = "Wiley-Blackwell",

number = "6",

}

van der Wel, MJ, Duits, LC , Pouw, RE, Seldenrijk, CA, Offerhaus, GJA, Visser, M, Ten Kate, FJ, Biermann, K, Brosens, LAA, Doukas, M, Huysentruyt, C, Karrenbeld, A, Kats-Ugurlu, G, van der Laan, JS, van Lijnschoten, GI, Moll, FCP, Ooms, AHAG, van der Valk, H, Tijssen, JG , Bergman, JJ & Meijer, SL 2018, 'Improved diagnostic stratification of digitised Barrett's oesophagus biopsies by p53 immunohistochemical staining', Histopathology, vol. 72, no. 6, pp. 1015-1023. https://doi.org/10.1111/his.13462

TY - JOUR

T1 - Improved diagnostic stratification of digitised Barrett's oesophagus biopsies by p53 immunohistochemical staining

AU - van der Wel, Myrtle J

AU - Duits, Lucas C

AU - Pouw, Roos E

AU - Seldenrijk, Cornelis A

AU - Offerhaus, G J A

AU - Visser, Mike

AU - Ten Kate, Fiebo J

AU - Biermann, Katharina

AU - Brosens, Lodewijk A A

AU - Doukas, Michael

AU - Huysentruyt, Clement

AU - Karrenbeld, Arend

AU - Kats-Ugurlu, Gursah

AU - van der Laan, Jaap S

AU - van Lijnschoten, G Ineke

AU - Moll, Freek C P

AU - Ooms, Ariadne H A G

AU - van der Valk, Hans

AU - Tijssen, Jan G

AU - Bergman, Jacques J

AU - Meijer, Sybren L

PY - 2018/5

Y1 - 2018/5

N2 - AIMS: Interobserver agreement for dysplasia in Barrett's oesophagus (BO) is low, and guidelines advise expert review of dysplastic cases. The aim of this study was to assess the added value of p53 immunohistochemistry (IHC) for the homogeneity within a group of dedicated gastrointestinal (GI) pathologists.METHODS AND RESULTS: Sixty-single haematoxylin and eosin (HE) slide referral BO cases [20 low-grade dysplasia (LGD); 20 high-grade dysplasia (HGD); and 20 non-dysplastic BO reference cases] were digitalised and independently assessed twice in random order by 10 dedicated GI pathologists. After a 'wash-out' period, cases were reassessed with the addition of a corresponding p53 IHC slide. Outcomes were: (i) proportion of 'indefinite for dysplasia' (IND) diagnoses; (ii) interobserver agreement; and (iii) diagnostic accuracy as compared with a consensus 'gold standard' diagnosis defined at an earlier stage by five core expert BO pathologists after their assessment of this case set. Addition of p53 IHC decreased the mean proportion of IND diagnoses from 10 of 60 to eight of 60 (P = 0.071). Mean interobserver agreement increased significantly from 0.45 to 0.57 (P = 0.0021). The mean diagnostic accuracy increased significantly from 72% to 82% (P = 0.0072) after p53 IHC addition.CONCLUSION: Addition of p53 IHC significantly improves the histological assessment of BO biopsies, even within a group of dedicated GI pathologists. It decreases the proportion of IND diagnoses, and increases interobserver agreement and diagnostic accuracy. This justifies the use of accessory p53 IHC within our upcoming national digital review panel for BO biopsy cases.

AB - AIMS: Interobserver agreement for dysplasia in Barrett's oesophagus (BO) is low, and guidelines advise expert review of dysplastic cases. The aim of this study was to assess the added value of p53 immunohistochemistry (IHC) for the homogeneity within a group of dedicated gastrointestinal (GI) pathologists.METHODS AND RESULTS: Sixty-single haematoxylin and eosin (HE) slide referral BO cases [20 low-grade dysplasia (LGD); 20 high-grade dysplasia (HGD); and 20 non-dysplastic BO reference cases] were digitalised and independently assessed twice in random order by 10 dedicated GI pathologists. After a 'wash-out' period, cases were reassessed with the addition of a corresponding p53 IHC slide. Outcomes were: (i) proportion of 'indefinite for dysplasia' (IND) diagnoses; (ii) interobserver agreement; and (iii) diagnostic accuracy as compared with a consensus 'gold standard' diagnosis defined at an earlier stage by five core expert BO pathologists after their assessment of this case set. Addition of p53 IHC decreased the mean proportion of IND diagnoses from 10 of 60 to eight of 60 (P = 0.071). Mean interobserver agreement increased significantly from 0.45 to 0.57 (P = 0.0021). The mean diagnostic accuracy increased significantly from 72% to 82% (P = 0.0072) after p53 IHC addition.CONCLUSION: Addition of p53 IHC significantly improves the histological assessment of BO biopsies, even within a group of dedicated GI pathologists. It decreases the proportion of IND diagnoses, and increases interobserver agreement and diagnostic accuracy. This justifies the use of accessory p53 IHC within our upcoming national digital review panel for BO biopsy cases.

KW - Barrett Esophagus/diagnosis

KW - Biomarkers/analysis

KW - Biopsy

KW - Humans

KW - Image Interpretation, Computer-Assisted/methods

KW - Immunohistochemistry

KW - Observer Variation

KW - Tumor Suppressor Protein p53/analysis

U2 - https://doi.org/10.1111/his.13462

DO - https://doi.org/10.1111/his.13462

M3 - Article

C2 - 29314176

SN - 0309-0167

VL - 72

SP - 1015

EP - 1023

JO - Histopathology

JF - Histopathology

IS - 6

ER -