Validation of an algorithm for the diagnosis of serous tubal intraepithelial carcinoma

Int J Gynecol Pathol. 2012 May;31(3):243-53. doi: 10.1097/PGP.0b013e31823b8831.


It has been reported that the diagnosis of serous tubal intraepithelial carcinoma (STIC) is not optimally reproducible on the basis of only histologic assessment. Recently, we reported that the use of a diagnostic algorithm that combines histologic features and coordinate immunohistochemical expression of p53 and Ki-67 substantially improves reproducibility of the diagnosis. The goal of the current study was to validate this algorithm by testing a group of 6 gynecologic pathologists who had not participated in the development of the algorithm (3 faculty and 3 fellows) but who were trained in its use by referring to a website designed for the purpose. They then reviewed a set of microscopic slides, which contained 41 mucosal lesions of the fallopian tube. Overall consensus (≥4 of 6 pathologists) for the 4 categories of STIC, serous tubal intraepithelial lesion (our atypical intermediate category), p53 signature, and normal/reactive was achieved in 76% of the lesions, with no consensus in 24%. Combining diagnoses into 2 categories (STIC versus non-STIC) resulted in an overall consensus of 93% and no consensus in 7%. The κ value for STIC versus non-STIC among all 6 observers was also high at 0.67 and did not significantly differ, whether for faculty (κ=0.66) or fellows (κ=0.60). These findings confirm the reproducibility of this algorithm by a group of gynecologic pathologists who were trained on a website for that purpose. Accordingly, we recommend its use in research studies. Before applying it to routine clinical practice, the algorithm should be evaluated by general surgical pathologists in a community setting.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Validation Study

MeSH terms

  • Algorithms*
  • Carcinoma in Situ / diagnosis*
  • Carcinoma in Situ / metabolism
  • Carcinoma in Situ / pathology
  • Fallopian Tube Neoplasms / diagnosis*
  • Fallopian Tube Neoplasms / metabolism
  • Fallopian Tube Neoplasms / pathology
  • Female
  • Humans
  • Ki-67 Antigen / metabolism
  • Observer Variation
  • Reproducibility of Results
  • Tumor Suppressor Protein p53 / metabolism


  • Ki-67 Antigen
  • Tumor Suppressor Protein p53