Small cell carcinoma of the lung and large cell neuroendocrine carcinoma interobserver variability
ABSTRACT To test the hypothesis that the published morphological criteria permit reliable segregation of small cell carcinoma of the lung (SCLC) and large cell neuroendocrine carcinoma (LCNEC) cases by determining the interobserver variation.
One hundred and seventy cases of SCLC, LCNEC and cases diagnosed as neuroendocrine lung carcinoma before LCNEC had been established as a diagnostic category were retrieved from the archives of the assessor's institutes. A representative haematoxylin and eosin section from each case was selected for review. Batches of cases were circulated among nine pathologists with a special interest in pulmonary pathology. Participants were asked to classify the cases histologically according to the 2004 World Health Organization (WHO) criteria. The diagnoses were collected and kappa values calculated. Unanimity of diagnosis was achieved for only 20 cases; a majority diagnosis was reached for 115 cases. In 35 cases no consensus diagnosis could be reached. There was striking variability amongst assessors in diagnosing SCLC and LCNEC. The overall level of agreement for all cases included in this study was fair (kappa=0.40).
Using non-preselected cases, the morphological WHO criteria for diagnosing SCLC and LCNEC leave room for subjective pathological interpretation, which results in imprecise categorization of SCLC and LCNEC cases.
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Conference Paper: Assistive technology enhancement using human factors engineering[Show abstract] [Hide abstract]
ABSTRACT: Over the past decade, there has been a steady increase in the number of people with disabilities attending college. This increase in student population numbers is also an indication of an increase in college-trained employable disabled persons. With the adoption of the Americans with Disabilities Act, reasonable accommodations that aid in the performance of essential functions of jobs must be afforded. The growth trend of persons with disabilities having an advanced technical education/training can be utilized more effectively by enhancing these job accommodations. This paper presents a review of human factors engineering (HFE) principles that should be considered in the job and work site design for the professional requiring some adjustment in traditional methods based on their physical, neurological, cognitive or sensory circumstances. The field of HFE has developed a variety of work design principles that apply not only to an able-bodied population but also to persons with disabilities. This paper reviews revised guiding principles and shows, through case studies and real-world examples, their applicability in job accommodation and workplace design. The case studies involve persons with varying degrees and forms of disabilities in the areas of neurological, orthopedic, cognitive, or sensory impairments. Common job site adjustments are considered using HFE revised guiding principles to make the assistive technology effective, transparent, aesthetic, and acceptable to the user. Areas where enhancements of assistive technology apply are in the job function assessment and training programs, technology support on the job, and workplace layout and designBiomedical Engineering Conference, 1997., Proceedings of the 1997 Sixteenth Southern; 05/1997
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ABSTRACT: Lung cancer classification is of paramount importance in determining the treatment for oncologic patients. Most lung cancers are non-small cell lung carcinomas (NSCLC), which are further subclassified into squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. Lung neuroendocrine tumors are subclassified into typical carcinoid, atypical carcinoid, small cell carcinoma, and large cell neuroendocrine carcinoma. In NSCLC in particular, the histologic classification and tumor mutation analysis are central to today's targeted therapy and personalized treatment. This article discusses the current diagnostic criteria for classification of NSCLC and lung neuroendocrine tumors and implications for oncologic treatment.Surgical Oncology Clinics of North America 10/2011; 20(4):637-53. DOI:10.1016/j.soc.2011.07.004 · 1.67 Impact Factor
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ABSTRACT: Small-cell lung carcinoma (SCLC) and large-cell neuroendocrine carcinoma (LCNEC) are categorized as high-grade neuroendocrine tumours because of their poor prognosis compared with those of other neuroendocrine tumours of the lung. There have been no clinicopathological studies focusing on small-sized high-grade neuroendocrine tumours. We analysed clinicopathological features of peripheral, small-sized high-grade neuroendocrine tumours of the lung retrospectively. A total of 28 patients with peripheral, small-sized tumours (maximum diameter of 3.0 cm) of SCLC and LCNEC underwent surgical resection in our hospital and were enrolled in this study. Of 28 tumours, 18 were SCLC and 10 were LCNEC. In terms of serum tumour marker levels, carcinoembryonic antigen was elevated in 50% of both types of tumour, and progastrin-releasing peptide was elevated in 28% of SCLC and 10% of LCNEC. With regard to preoperative diagnosis, only seven SCLC cases were correctly diagnosed as SCLC, but no LCNEC case was correctly diagnosed before surgery. Lymphatic involvement was significantly more frequent in SCLC than in LCNEC (P = 0.013). Although adjuvant chemotherapy was carried out more frequently in the patients with SCLC than LCNEC, the recurrence rate after the standard surgery was significantly higher in the patients with SCLC than LCNEC (P = 0.0037). There was a significant difference between SCLC and LCNEC in terms of overall survival in clinical-stage IA small-sized tumours (P = 0.029). In peripheral, small-sized high-grade neuroendocrine tumours, there are several clinicopathological differences between SCLC and LCNEC. This study suggested that the prognosis of patients with LCNEC tended to be better than for those with SCLC in small-sized tumours.European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 12/2011; 41(4):841-6. DOI:10.1093/ejcts/ezr132 · 2.81 Impact Factor