The contribution of MIB 1 in the accurate grading of vulvar intraepithelial neoplasia

J Clin Pathol. 1999 Nov;52(11):820-4. doi: 10.1136/jcp.52.11.820.

Abstract

Aim: To determine the interobserver variation in scoring presence and grade of vulvar intraepithelial neoplasia (VIN) in haematoxylin/eosin (H/E) slides, MIB 1 slides, and the combined use of H/E and MIB 1 slides.

Methods: 10 slides were stained with H/E and MIB 1 with each of the following diagnoses: normal vulvar skin, VIN 1, VIN 2, and VIN 3. Six observers first scored the H/E slides separately from the MIB 1 slides and second the combined H/E and MIB 1 slides.

Results: Unweighted group kappa for MIB 1 was 0.62 and the weighted group kappa was 0.91. This was significantly better than the unweighted group kappa for H/E slides (0.47, p = 0.023) as well as the weighted group kappa for H/E slides (0.82, p = 0.014). There was no improvement by the combined use of H/E and MIB 1 slides. VIN 2 is far less confused with VIN 3 in the combined use of H/E and MIB 1 slides (9%) than in H/E slides (38%) (p = 0.007). There is a tendency to grade VIN in a two tailed grading system rather than a three tailed grading system, which became more apparent with the combined use of H/E and MIB 1 slides.

Conclusions: The interobserver variation with sole use of MIB 1 is better than with the use of H/E stain in VIN. The use of MIB 1 in grading VIN diminishes confusion between VIN 2 and VIN 3 fourfold. A two tailed grading system for VIN seems already to work in daily practice.

MeSH terms

  • Antibodies, Monoclonal
  • Antigens, Neoplasm / analysis*
  • Antigens, Nuclear
  • Carcinoma in Situ / immunology
  • Carcinoma in Situ / pathology*
  • Eosine Yellowish-(YS)
  • Female
  • Hematoxylin
  • Humans
  • Ki-67 Antigen / analysis*
  • Nuclear Proteins / immunology
  • Observer Variation
  • Sensitivity and Specificity
  • Vulva / immunology
  • Vulvar Neoplasms / immunology
  • Vulvar Neoplasms / pathology*

Substances

  • Antibodies, Monoclonal
  • Antigens, Neoplasm
  • Antigens, Nuclear
  • Ki-67 Antigen
  • Nuclear Proteins
  • Eosine Yellowish-(YS)
  • Hematoxylin