Variabilidade interobservador no diagnóstico da doença trofoblástica gestacional: um estudo na residência de patologia da Universidade Federal do Ceará

Abstract

Objective: To analyze interobserver variability in the histopathological diagnosis of gestational trophoblastic disease (GTD). Methodology: Fifty cases of GTD were randomly selected from the Department of Pathology of the Federal University of Ceará, classified in the original report as 31 complete moles, 15 partial moles and 4 non classified. A single slide from each case was evaluated by a resident physician and a gynecological pathologist, which diagnosis was considered as a reference. Original report was applied for correlation as well. Beta-HCG values was correlated with mole type, when provided. Kappa values were calculated for interobserver variability. Results: Overall interobserver agreement was poor (ĸ = 0.25), between resident x gynecological pathologist and resident x original report the kappa values were respectively ĸ = 0.16 and ĸ = 0.38. Concordance was moderate (ĸ = 0.41) even between the gynecological pathologist and the original report. Beta-HCG values higher than 100.000 mIU/ml were seen in 7 complete and 4 partial moles. Conclusion: Interobserver agreement for the diagnosis of GTD ranged from poor to moderate when histology was the only diagnostic tool. High beta-HCG value was more frequent in complete moles