elastin and Peritoneal-Neoplasms

Local peritoneal involvement (LPI) and extramural venous invasion (EMVI) are of prognostic value in Dukes' B colonic cancers and may be used to select patients for adjuvant chemotherapy. There is marked variation in the frequency with which they are reported however, ranging from 7% to 39% and 10% to 90%, respectively. A grading system for diagnosing LPI has been proposed by Shepherd et al. and partially incorporated into the Royal College of Pathologists guidelines for reporting colorectal cancer. This study aimed to determine the degree of interobserver variation in the reporting of LPI and EMVI amongst a group of experienced pathologists with a special interest in gastrointestinal pathology.. Four pathologists specialising in gastrointestinal pathology independently assessed LPI according to the grading system described by Shepherd et al. and the presence or absence of EMVI on 138 and 131 slides of pT3 and pT4 colonic cancers, respectively. Kappa statistics were performed to assess interobserver agreement. Kappa values for LPI ranged from kappa = 0.74 (substantial agreement) to kappa = 0.89 (almost perfect agreement). Kappa values for EMVI ranged from kappa = 0.29 (poor agreement) to kappa = 0.59 (moderate agreement).. Using Shepherd's grading system there was good agreement between pathologists in reporting LPI in colonic carcinomas. The reporting of EMVI in colonic carcinomas on haematoxylin and eosin-stained slides had only poor to moderate agreement however, even amongst gastrointestinal pathologists working together in a single unit. Introduction of standardized criteria and/or the use of an elastin stain in the diagnosis of EMVI may assist in improving interobserver agreement.

Topics: Colonic Neoplasms; Elastin; Eosine Yellowish-(YS); Hematoxylin; Histological Techniques; Humans; Neoplasm Invasiveness; Observer Variation; Peritoneal Neoplasms; Prognosis; Retrospective Studies

To determine whether elastin stains aid in classifying peritoneal implants associated with ovarian serous borderline tumours (SBT).. The study group comprised 80 implants (nine invasive and 71 non-invasive) from 28 patients with ovarian SBT. Elastin stains were performed using histochemical and immunohistochemical methods to demonstrate the peritoneal elastic lamina (PEL), and evaluated with regard to assessment of the subtype of implant. The elastin stains demonstrated the PEL in most anatomical sites other than the omentum and the bladder and were considered helpful in 44/80 (55%) cases. The stains were most useful in the assessment of poorly oriented or traumatized biopsy specimens and in confirming the superficial distribution of non-invasive implants. The staining was non-contributory in most of the remaining biopsies, because the PEL was not identified.. Demonstration of the PEL using elastin stains can be useful in the subclassification of implants associated with ovarian SBT and is of most value in confirming the superficial distribution of non-invasive lesions. However, evaluation is limited by the absence of a defined elastic layer in a proportion of biopsy specimens, possibly reflecting their superficial location, as well as absence of a distinct PEL in sites such as the omentum.

Topics: Adult; Aged; Aged, 80 and over; Cystadenocarcinoma, Serous; Elastin; Female; Humans; Immunohistochemistry; Middle Aged; Ovarian Neoplasms; Peritoneal Neoplasms; Peritoneum; Predictive Value of Tests