Stability of diagnostic rate in a cohort of 38,813 colorectal polyp specimens and implications for histomorphology and statistical process control

Bonert, Michael; Naqvi, Asghar; Rahman, Mozibur; Marshall, John K.; Xenodemetropoulos, Ted; Arora, Paul; Slater, Justin; Major, Pierre

doi:10.1038/s41598-021-95862-2

Cited by 2 publications

(2 citation statements)

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“…Our prior work examining diagnostic consistency suggests that pathologists have stable diagnostic rates [ 21 ] and that those rates with individualized feedback are modifiable, i.e. the diagnostic consistency could be improved via next generation quality [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

What is your count? An observational study of lymph node counting in 2,028 colorectal cancer resections

Srivastava,

Kak,

Major

et al. 2024

PLoS ONE

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Background Lymph node status and lymph node count (LNC) are predictors of colorectal cancer outcome. Under-sampling of lymph nodes may lead to clinically relevant stage migration. Methods Colorectal cancer (CRC) cases with a synoptic report, accessioned 2012–2020 at a regional laboratory, were extracted and retrospectively studied. LNC, positive lymph node count (PLNC), tumour deposits present (TDpos), and ‘y’ (staging) prefix (YS) were retrieved and tabulated by pathologist using custom software. Statistical analyses were done with R. Data and results The cohort had 2,543 CRC resections. Seventeen pathologists interpreted >50 cases (range: 56–356) each and collectively saw 2,074. After cases with unavailable data were purged, 2,028 cases remained with 43,996 lymph nodes, of which 2,637/43,996 were positive. 368 cases had a ‘y’ prefix, and 379 had TDpos. The 17 pathologists’ median LNC/case was 19.0 (range: 14.0–24.0), and the mean PLNC per case was 1.4 (range: 1.0–2.0). Kruskal-Wallis rank sum tests showed there were differences in LNC (p<0.001) among pathologists; however, PLNC did not show this association (p = 0.2917). T-tests showed that mean LNC (p<0.001) and PLNC (p<0.035) differed between YS. 138 of 2,028 cases had less than the 12 LNC target. Logistic regression revealed a strong association between meeting the LNC target and pathologist (p<0.001) but TDpos was non-predictive (p = 0.4736). Conclusions Positive lymph node call rate has a good consistency in the laboratory; however, lymph node count varies significantly between pathologists. Standardized counting criteria are needed to improve uniformity and could be aided by synoptic reporting data.

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Section: Discussionmentioning

confidence: 99%

What is your count? An observational study of lymph node counting in 2,028 colorectal cancer resections

Srivastava,

Kak,

Major

et al. 2024

PLoS ONE

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“…The project builds on work previously performed by our group dealing with lung core biopsies, [11] and on knowledge acquired parsing free text pathology reports [12,13].…”

Section: Ethics Statementmentioning

confidence: 99%

Neuroanatomical location of brain metastases from solid tumours based on pathology: An analysis of 511 patients with a comparison to the provided clinical history

Bonert,

Berzins,

Begum

et al. 2023

PLoS ONE

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Brain metastases are a frequent occurrence in neuropathology practices. The literature on their neuroanatomical location is frequently derived from radiological analyses. This work examines brain metastases through the lens of pathology specimens. All brain surgical pathology reports for cases accessioned 2011–2020 were retrieved from a laboratory. Specimens were classified by neuroanatomical location, diagnosis and diagnostic category with a hierarchical free text string-matching algorithm (HFTSMA) and also subsequently audited. All reports classified as probable metastasis were reviewed by a pathologist. The provided history was compared to the final categorization by a pathologist. The cohort had 4,625 cases. The HFTSMA identified 854 cases (including metastases from a definite primary, metastases from primary not known and improperly classified cases). 514/854 cases had one definite primary site per algorithm and on report review 538/854 cases were confirmed as such. The 538 cases originated from 511 patients. Primaries from breast, gynecologic tract, and gastrointestinal tract not otherwise specified were most frequently found in the cerebellum. Kidney metastases were most frequently found in the occipital lobe. Lung, metastatic melanoma and colorectal primaries were most commonly found in the frontal lobe. The provided clinical history predicted the primary in 206 cases (40.3%), was discordant in 17 cases (3.3%) and non-contributory in 280 cases (54.8%). The observed distribution of the metastatic tumours in the brain is dependent on the primary site. In the majority (54.8%) of cases, the provided clinical history was non-contributory; this suggests surgeon-pathologist communication may have the potential for optimization.

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Stability of diagnostic rate in a cohort of 38,813 colorectal polyp specimens and implications for histomorphology and statistical process control

Cited by 2 publications

References 10 publications

What is your count? An observational study of lymph node counting in 2,028 colorectal cancer resections

What is your count? An observational study of lymph node counting in 2,028 colorectal cancer resections

Neuroanatomical location of brain metastases from solid tumours based on pathology: An analysis of 511 patients with a comparison to the provided clinical history

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