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Biopsies from the \u201cPrevent<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\u201d study, a multinational\u2010 prospective\u2010 randomized study in children with at least one\u2010first\u2010degree relative with <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> and positive for <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DQ<\/jats:styled-content>2\/<jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DQ<\/jats:styled-content>8. Ninety\u2010eight biopsies were evaluated. Considering diagnostic samples with villous atrophy (<jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>), the agreement was satisfactory (\u03ba = 0.84), but much less when assessing the severity of these lesions. The use of the recently proposed Corazza\u2010Villanacci classification showed a moderately higher level of agreement (\u03ba = 0.39) than using the Marsh\u2010Oberhuber system (\u03ba = 0.31). 57.1% of cases were considered correctly oriented. A number of &gt;4 samples per patient was statistically associated to a better agreement; orientation did not impact on \u03ba values. Agreement results in this study appear more satisfactory than in previous papers and this is justified by the involvement of centers with experience in <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> diagnosis and by the well\u2010controlled setting. Despite this, the reproducibility was far from optimal with a poor agreement in grading the severity of <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>. Our results stress the need of a minimum of four samples to be assessed by the pathologist.<\/jats:p>","DOI":"10.1111\/apm.12812","type":"journal-article","created":{"date-parts":[[2018,1,26]],"date-time":"2018-01-26T06:16:49Z","timestamp":1516947409000},"page":"208-214","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Histopathological evaluation of duodenal biopsy in the PreventCD project. 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