Adrenocortical Tumors: Improving the Practice of the Weiss System Through Virtual Microscopy A National Program of the French Network INCa-COMETE

作者：Tissier Frederique^*; Aubert Sebastien; Leteurtre Emmanuelle; Al Ghuzlan Abir; Patey Martine; Decaussin Myriam; Doucet Laurent; Gobet Francoise; Hoang Catherine; Mazerolles Catherine; Monges Genevieve; Renaudin Karine; Sturm Nathalie; Trouette Helene; Vacher Lavenu Marie Cecile; Viallon Vivian; Baudin Eric; Bertagna Xavier; Coste Joel; Libe Rossella

来源：American Journal of Surgical Pathology, 2012, 36(8): 1194-1201.

DOI：10.1097/PAS.0b013e31825a6308

• adrenal
• adrenocortical tumors
• adrenocortical adenoma
• adrenocortical carcinoma
• Weiss system
• virtual microscopy

The Weiss score is the reference method to distinguish between a benign and a malignant adrenocortical tumor (ACT). A program was initiated to improve the reproducibility of the pathologic diagnosis of ACTs in France through the National INCa-COMETE Network. Twelve pathologists from all Reference Centers of the Network analyzed 50 selected ACTs using a web-based virtual microscopy approach in a blind design, allowing to determine the intraobserver and interobserver reproducibilities of the Weiss system. All ACTs were read twice in random order before and after a coaching meeting organized to harmonize and improve analyses and create an online tutorial. The validity of the virtual approach was first established by comparing the 2 consensuses (virtual and microscopic) obtained for each tumor by 3 pathologists who performed the 2 approaches in a blinded manner. For the %26quot;dichotomized Weiss score%26quot; (separating malignant %26gt;= 3 from benign %26lt;= 2 tumors) interobserver reproducibility was %26quot;substantial%26quot; at the first %26quot;virtual%26quot; reading (kappa = 0.70) and increased at the second %26quot;virtual%26quot; reading (kappa = 0.75). In parallel, 7 of the 9 items of the Weiss system showed improvement. The diagnostic accuracy of the observers as a group, using the modal group score approach, showed an improved sensitivity from 86% to 95% for the diagnosis of malignant ACTs. We show the validity of the virtual microscopy approach and that the program improved the practice of the Weiss system reading and therefore the diagnosis of ACT. This tool can now be extended for other research and/or routine purposes in this rare cancer.

• 出版日期2012-8