Author/Editor     Pelt, Gabi W; Dequeker, Elisabeth MC; Al Dieri, Raed; Tollenaar, Rob AEM; van Krieken, Han J. J. M.; Mesker, Wilma E; Zidar, Nina
Title     e-Learning for instruction and to improve reproducibility of scoring tumor-stroma ratio in colon carcinoma
Type     članek
Vol. and No.     Letnik 5, št. 3
Publication year     2021
Volume     str. 1-9
ISSN     2561-326X
Language     eng
Abstract     Background: The amount of stroma in the primary tumor is an important prognostic parameter. The tumor-stroma ratio (TSR) was previously validated by international research groups as a robust parameter with good interobserver agreement. Objective: The Uniform Noting for International Application of the Tumor-Stroma Ratio as an Easy Diagnostic Tool (UNITED) study was developed to bring the TSR to clinical implementation. As part of the study, an e-Learning module was constructed to confirm the reproducibility of scoring the TSR after proper instruction. Methods: The e-Learning module consists of an autoinstruction for TSR determination (instruction video or written protocol) and three sets of 40 cases (training, test, and repetition sets). Scoring the TSR is performed on hematoxylin and eosin%stained sections and takes only 1-2 minutes. Cases are considered stroma-low if the amount of stroma is %50%, whereas a stroma-high case is defined as >50% stroma. Inter- and intraobserver agreements were determined based on the Cohen % score after each set to evaluate the reproducibility. Results: Pathologists and pathology residents (N=63) with special interest in colorectal cancer participated in the e-Learning. Forty-nine participants started the e-Learning and 31 (63%) finished the whole cycle (3 sets). A significant improvement was observed from the training set to the test set; the median % score improved from 0.72 to 0.77 (P=.002). Conclusions: e-Learning is an effective method to instruct pathologists and pathology residents for scoring the TSR. The reliability of scoring improved from the training to the test set and did not fall back with the repetition set, confirming the reproducibility of the TSR scoring method.
Keywords     colon cancer
tumor-stroma ratio
validacija
rak debelega črevesa
razmerje med tumorjem in stromo
validation