Inter-Observator Variability and the Value of Histological Examination in the Classification of Ampullary Carcinomas - Abstract
The ampullary carcinomas represent 7% of carcinoma arising in pancreatobiliary region. Adenocarcinoma is the dominant histological type, observed in 90% of cases. The determination of the intestinal or pancreatobiliary origin have a double interests; prognostic and therapeutic. The aim of this study is to evaluate the value of histological examination in determining the origin of ampullary carcinomas.
We reviewed 35 cases of ampullarytumors, collected in the Department of Pathology of Hassan II university Hospital of Fez (Morocco) over a period of 2 years. Two pathologists reviewed, independently, all the cases, without clinical or radiological information. They were based on histological criteria defined in the WHO classification of digestive tumours. The Kappa coefficient is used to assess agreement.
Our study showed a medium reproducibility of histological examination in the diagnosis of ampullary carcinomas, with good agreement for the intestinal type. The distinction between these histological subtypes is required given its prognostic and therapeutic implications. The standard histological examination allows in most cases the determination of intestinal or biliopancreatic origin, based on architectural criteria and cyto-nuclear. Using immune histochemical supplements prove necessary in the loss morphological criteria or discordant cases overlap.