{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T16:24:37Z","timestamp":1787934277001,"version":"build-2784847793"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T00:00:00Z","timestamp":1634083200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Fundic gland polyps (FGPs) arise sporadically and in combination with familial adenomatous polyposis (FAP). Criteria for distinguishing low\u2010grade dysplasia (LGD) from regenerative atypia in FGPs are not well established. The aims of study were to determine: (i) interobserver variability in diagnosing LGD in FGPs; (ii) bias in diagnosing LGD in FAP patients; and (iii) stringent criteria for LGD in FGPs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Five senior pathologists who were blinded to the clinical history reviewed 72 FAP\u2010associated FGPs and 34 sporadic FGPs. Cases were classified as negative (score\u2009=\u20090) or positive (score\u2009=\u20091) for LGD. Each case was assigned a \u2018combined dysplasia score\u2019 (CDS) ranging from 0 to 5 to reflect all five opinions. Fleiss\u2019 kappa showed only moderate interobserver agreement (<jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.46). Forty\u2010one FGPs were classified as negative for dysplasia by consensus (CDS\u2009=\u20090\u20131), including 10 (24%) originally diagnosed as LGD. In contrast, all 37 cases classified as LGD by consensus (CDS\u2009=\u20094\u20135) were originally diagnosed as LGD, indicating that overdiagnosis of dysplasia is more common than underdiagnosis (<jats:italic>P<\/jats:italic>\u2009=\u20090.0012). Cytological atypia in the surface epithelium and an abrupt transition between atypical and normal\u2010appearing epithelium were the most sensitive (97% and 100%, respectively) and specific (100% and 98%, respectively) features of dysplasia (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001 for both comparisons). Very good agreement was achieved when a diagnosis of dysplasia was based on the presence of both features (<jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.85).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is high interobserver variability and a tendency to overdiagnose LGD in FGPs. Strict criteria requiring both surface atypia and abrupt transition for LGD in FGPs result in low interobserver variability.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.14549","type":"journal-article","created":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T14:44:06Z","timestamp":1629729846000},"page":"314-321","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["High interobserver variability and frequent overdiagnosis of dysplasia in fundic gland polyps can be improved by detecting atypia on the surface epithelium and an abrupt transition to non\u2010neoplastic cells"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7742-0810","authenticated-orcid":false,"given":"Christine E","family":"Orr","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Beneck","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1692-9880","authenticated-orcid":false,"given":"Jose","family":"Jessurun","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihui","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Tyryshkin","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Medicine Queen\u2019s University Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhonda K","family":"Yantiss","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao\u2010Tseng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,13]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"40","article-title":"Changing trends in gastric polyps","volume":"70","author":"Vel\u00e1zquez\u2010Dohorn ME","year":"2018","journal-title":"Rev. Invest. Clin."},{"key":"e_1_2_8_3_1","first-page":"12","article-title":"Prevalence of histological types of gastric polyps in adult patients from a public hospital in Lima\u2010Peru (2007\u20132016)","volume":"39","author":"Siccha\u2010Sinti C","year":"2019","journal-title":"Rev. Gastroenterol. 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