An Evaluation Into the Robustness of Grading of Pleural Mesothelioma Outside of Specialist Centres. in APMIS : acta pathologica, microbiologica, et immunologica Scandinavica / APMIS. 2025 Mar;133(3):e70006. doi: 10.1111/apm.70006.

2025

Tipo pubblicazione

Journal Article;

Autori/Collaboratori (18)Elenco ridotto...

Prabhakaran S
Department of Anatomical Pathology, Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia.
Hocking AJ
Department of Anatomical Pathology, Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia.
Irani Y
Department of Anatomical Pathology, Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia.
Hussey M
Department of Anatomical Pathology, Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia.
Alexeyenko A
Department of Anatomical Pathology, SA Pathology and Flinders University, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Dobra K
Science for Life Laboratory, Solna, Sweden.
Micsik T
Evi-Networks Consulting, Huddinge, Sweden.
Duhig E
Department of Cellular and Molecular Biology, Karolinska Institutet, Solna, Sweden.
Walts AE
Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
Vanwalleghem L
Department of Clinical Pathology and Cytology, Karolinska University Hospital Solna, Stockholm, Sweden.
Chhut V
Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
Roden AC
Department of Clinical Pathology and Cytology, Karolinska University Hospital Solna, Stockholm, Sweden.
Roggli VL
Sullivan Nicolaides Pathology, Brisbane, Queensland and John Flynn Private Hospital, Tugun, Queensland, Australia.
Hertoghs M
Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Galateau-Salle F
Department of Pathology, AZ Sint Jan Bruges, Bruges, Belgium.
Brcic L
Department of Pathology, University of Health Sciences, Phnom Penh, Cambodia.
Moffat D
Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, Minnesota, USA.
Klebe S
Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA.

Abstract

The 2021 WHO classification of thoracic tumours recommends grading pleural mesothelioma to aid prognostication. Robustness of grading and morphological characterisation is key to its clinical utility, though validation of this grading system has largely been conducted by expert thoracic pathologists. We conducted a survey inviting pathologists across a range of practices and expertise to grade digitised images of 50 epithelioid pleural mesotheliomas that had been graded by an expert in thoracic pathology. We included slides that were considered potentially problematic such as small biopsies, focal necrosis, and rare subtypes that may affect grading (small cell and deciduoid features). Using the Sectra Uniview web viewer, participants were asked to score atypia, mitotic count, and necrosis and choose from a list of cytological and architectural features. Seventy-four pathologists anonymously participated. There was 90% agreement of consensus scores with expert opinion using the WHO 2-tier grade and 72% for the 3-tier nuclear grade but only 70% for nuclear atypia, 56% for mitoses, and 84% for necrosis. Both 3-tier nuclear grade and WHO 2-tier grading systems were significantly associated with survival. Our study affirms the overall robustness and utility of grading for pleural mesothelioma, reveals variances, and suggests the need for dedicated training.

PMID : 40017229

DOI : 10.1111/apm.70006

Keywords

Humans; Pleural Neoplasms/pathology/diagnosis; Neoplasm Grading; Mesothelioma/pathology/diagnosis; Male; Female; Middle Aged; Mesothelioma, Malignant/pathology/diagnosis; Pathologists; Aged; Surveys and Questionnaires; Prognosis; Necrosis;