Endoscopy 2021; 53(12): 1250-1255
DOI: 10.1055/a-1331-4446
Innovations and brief communications

Interobserver reliability of methods to determine complete resection of adenomas in colonoscopy

1  Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
,
William Barge
2  Division of Gastroenterology and Hepatology, University of Wisconsin, Madison, Wisconsin, USA
,
Jason Kramer
3  Division of Digestive Diseases and Nutrition, Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
,
Bana Alajati
3  Division of Digestive Diseases and Nutrition, Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
,
Shriram Jakate
4  Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA
,
David Cimbaluk
4  Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA
,
Deborah Giusto
5  4Path Pathology Services Laboratory, Burr Ridge, Illinois, USA
,
Ethan Ritz
6  Clinical Informatics and Biostatistics, Rush University Medical Center, Chicago, Illinois, USA
,
Faraz Bishehsari
3  Division of Digestive Diseases and Nutrition, Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
,
Saline Lee
3  Division of Digestive Diseases and Nutrition, Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
,
Shubha Singh
3  Division of Digestive Diseases and Nutrition, Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
,
John Losurdo
3  Division of Digestive Diseases and Nutrition, Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
,
Michael Brown
3  Division of Digestive Diseases and Nutrition, Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
,
Mark DeMeo
3  Division of Digestive Diseases and Nutrition, Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
,
Rana Abraham
3  Division of Digestive Diseases and Nutrition, Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
,
Karen Ma
3  Division of Digestive Diseases and Nutrition, Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
,
Joshua Melson
3  Division of Digestive Diseases and Nutrition, Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
› Author Affiliations
Supported by: Boston Scientific Corporation, Swim Across America Grant 56618

Trial Registration: ClinicalTrials.gov Registration number (trial ID): NCT02217085 Type of study: Prospective

Abstract

Background Forceps margin biopsy and polypectomy specimen margins have both been used to assess for polypectomy resection adequacy. The interobserver reliability of the two methods has not been well described.

Methods The interpretability of polypectomy specimens for presence of residual neoplasia at the margin was assessed by two blinded pathologists. Next, the concordance of forceps margin biopsy interpretations between three blinded pathologists was evaluated by calculation of interobserver κ.

Results Rates of polypectomy specimen margin interpretability were low: 24/92 (26 %) for pathologist A, 28/92 (30.4 %) for pathologist B. Concordance of forceps margin biopsy interpretations (n = 129) between pathologists was high. Two internal pathologists showed substantial agreement in margin biopsy interpretations (κ 0.779; 95 %CL 0.543, 0.912). The concordance remained strong after biopsies were reviewed by a third, external pathologist (κ 0.829; 95 %CL 0.658, 0.924). There was complete agreement on 123/129 (95.3 %) between all three pathologists for presence of neoplasia.

Conclusion The majority of polypectomy specimen margins were uninterpretable by pathologists for presence of residual neoplasia. Forceps margin biopsy shows strong interobserver reliability in adenomatous lesions.



Publication History

Received: 28 May 2020

Accepted after revision: 07 December 2020

Publication Date:
07 December 2020 (online)

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