[Dysplasia in gastrointestinal mucosa: Interobserver variability and value of histological examination in the diagnosis of these lesions]

Abstract

Dysplasia is a preneoplastic lesion. Histological diagnosis is based on the presence of architectural and cytological modifications, and dedifferentiation, which the intensity is variable. Dysplasia is commonly graded as low and high grade. We achieved a retrospective study of 90 cases of gastrointestinal dysplasia collected in the Department of Pathology of Hassan II university hospital of Fez, during a period of 3 years. The cases were reviewed independently and blindly without clinical information by two pathologists. Their diagnoses were compared to the initial diagnosis. Interobserver concordance in the diagnosis of the degree of dysplasia was evaluated. The average age of our patients was 56 years oldwithout predominance of sex. The interobserver concordance in the diagnosis of digestive dysplasia between the three pathologists was moderate (with a Kappa estimated at 0.42). Concordant diagnosis for digestive low grade dysplasia was observed in 50 cases of the 55 cases (90%) and only 18 cases of high-grade dysplasia of 35 cases studied (50%). The agreement for the low-grade dysplasia is more significant. However, there is significant variation in the analysis of high-grade dysplasia. This work reveals a moderate reproducibility in the diagnosis of gastrointestinal dysplasia lesions and mostly well marked for high-grade dysplasia.

Keywords: Dysplasia; Dysplasie; Examen histologique.; Histological examination.; Interobservator variability; Mucosa; Muqueuse; Variabilité interobservateur.