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Pancreatic Neoplasms: HELP
Articles by Heewon A. Kwak
Based on 1 article published since 2010
(Why 1 article?)
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Between 2010 and 2020, Heewon A. Kwak wrote the following article about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Article Interobserver variability in intraductal papillary mucinous neoplasm subtypes and application of their mucin immunoprofiles. 2016

Kwak, Heewon A / Liu, Xiuli / Allende, Daniela S / Pai, Rish K / Hart, John / Xiao, Shu-Yuan. ·Department of Pathology, University of Chicago, Chicago, IL, USA. · Department of Pathology, University of Florida, Gainesville, FL, USA. · Department of Pathology, Cleveland Clinic Foundation, Cleveland, OH, USA. · Department of Pathology, Mayo Clinic, Scottsdale, AZ, USA. ·Mod Pathol · Pubmed #27198568.

ABSTRACT: Intraductal papillary mucinous neoplasm is considered a precursor lesion to pancreatic adenocarcinoma. These are further classified into four histologic subtypes: gastric, intestinal, pancreatobiliary, and oncocytic. The first aim of this study was to assess the interobserver variability among five gastrointestinal pathologists in diagnosing intraductal papillary mucinous neoplasm subtypes by morphology alone. The second aim of the study was to compare intraductal papillary mucinous neoplasm subtypes, which received consensus diagnoses (≥80% agreement) with their respective mucin immunoprofiles (MUC1, MUC2, MUC5AC, MUC6, and CDX2). A consensus histologic subtype was reached in 58% of cases (29/50) among the five gastrointestinal pathologists. Overall there was moderate agreement (κ=0.41, P<0.01) in subtyping intraductal papillary mucinous neoplasms without the use of immunohistochemistry. The histologic subtype with the best interobserver agreement was intestinal type (κ=0.56, P<0.01) followed by pancreatobiliary, gastric, mixed, and oncocytic types (κ=0.43, P<0.01; κ=0.38, P<0.01; κ=0.17, P<0.01; κ=0.08, P<0.04, respectively). Both kappa values for mixed and oncocytic subtypes were likely artificially low due to the underrepresentation of these subtypes in this study and not a true indication of poor interobserver agreement. Following an intradepartmental consensus meeting between two gastrointestinal pathologists, 68% of cases (34/50) received a consensus intraductal papillary mucinous neoplasm subtype. Sixty-nine percent of cases (11/16) that did not receive a consensus intraductal papillary mucinous neoplasm subtype could be classified based on their respective immunoprofiles. Standardizing the use of immunohistochemistry with a mucin immunopanel (MUC1, MUC2, MUC5AC, and MUC6) may improve the agreement of diagnosing intraductal papillary mucinous neoplasm histologic subtypes.