How reliable is the pathologist's diagnosis of endometriosis: a prospective inter-observer and intra-observer analysis
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Abstract
Purpose Laparoscopy is a very accurate diagnostic tool for endometriosis. However, diagnostic accuracy has been questioned, as there is no reliable link between the visual status of the peritoneal cavity reported by laparoscopy and the patient's clinical condition. In addition, there is no actual association between the presence of typical peritoneal lesions and its confirmation by means of pathologic examination. The aim of our study was to determine whether histologic microscopic assessment is a reliable method for the diagnosis of endometriosis. Methods We performed a prospective transversal study with 68 women with suggestive history of endometriosis who underwent laparoscopy. After biopsy, an intra-observer and inter-observer variability of the histologic study was analyzed by the Kappa integrity test to reveal whether microscopic examination is an accurate exam for the diagnosis of endometriosis. Results In 38 of the 68 slides, all examiners confirmed the presence of endometriosis (55.9%). The intra-observer analysis showed an individual agreement degree over 92 (kappa=0.85; P<.001), and the inter-observer analysis showed an overall agreement of 76.5 (k=0.78; P<.001). Conclusions The results showed a high level of integrity of the histologic exam for the diagnosis of endometriosis and confirmed that microscopic histology is a reliable and reproducible diagnostic tool for endometriosis.
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