Consistency of the histologic diagnosis of Lauren's classification of gastric cancer

• Published in: Medicina clínica Vol. 98; no. 15; p. 572
• Main Authors: Sanz, J M, Agudo, A, García-Julián, G, Ortego, J, Ruiz, J M, Arnal, F, Serrano, A
• Format: Journal Article
• Language: Spanish
• Published: Spain 18-04-1992
• Subjects: Case-Control Studies; Humans; Observer Variation; Predictive Value of Tests; Sensitivity and Specificity; Stomach Neoplasms - pathology
• ISSN: 0025-7753

Lauren's classification of gastric cancer is usually followed in epidemiological studies thus requiring evaluation of its reproducibility. This classification defines 2 principal histological types: intestinal and diffuse with different proportions in high and low risk areas possibly being associated to different causal factors.
The concordance diagnosis in an aleatory sample of 81 gastric carcinomas stratified according to the participation of 14 hospitals in an epidemiological study of 354 cases and 354 controls was analyzed. The initial diagnosis carried out was compared by more than 20 pathologists with the reclassification diagnosis by consensus of 2 pathologists by the proportion of agreement or concordance observed in the kappa index. Keeping the final reclassification by consensus as a reference, sensitivity, specificity and predictive values were also calculated.
The proportion of concordance observed was of 78% for the intestinal and 90% for the diffuse with a kappa index of 0.55 and 0.74, respectively. Sensitivity for the intestinal type was of 88% and for the diffuse 81% with specificity being of 67% in the intestinal and 93% in the diffuse.
Subjectivity in the interpretation of certain parameters necessary for histological diagnosis may be reduced by the elaboration of protocols in which the principal histological criteria to follow are detailed. Nonetheless, the distinction made between the two principal types, intestinal and diffuse, is valid enough to be used in multicenter epidemiological studies and in comparative studies.