Immunohistochemical Characterization Improves the Reproducibility of the Histological Diagnosis of Ovarian Carcinoma

Abstract

Background: Ovarian cancer is the leading cause of gynecologic cancer-related death. Histological<br />assessment remains the standard clue for the diagnosis of ovarian carcinoma. Misinterpretation and inconsistent<br />application of histological criteria may lead to significant interobserver variability and poor reproducibility of<br />the diagnosis. In this study, we investigated the discrepancy in histological diagnosis and the significance of a designed<br />panel of immunohistochemical markers for the improvement of the diagnostic reproducibility of ovarian carcinomas.<br />Methods: We performed a retrospective study on 74 ovarian carcinomas. All tumor slides were independently<br />reviewed by two pathologists. The results for seven available immunomarkers as p53, WT-1, p16INK4A, CK7,<br />CK20, and estrogen and progesterone receptors were determined for all cases by immunohistochemistry. Results:<br />The histological diagnosis review performed using standard histology showed a concordance of diagnoses in 86% of<br />cases with Cohen's kappa of 0.80. Immunohistochemical results increased significantly the diagnosis reproducibility<br />with a concordance of 91% and a Cohen's kappa of 0.86 (P = 0.001). Conclusion: Although the histological diagnosis<br />remains reliable, the use of a designed panel of immunohistochemical markers improves significantly the interobserver<br />concordance and the classification accuracy of ovarian carcinomas.