Journal Article
. 2001 Feb;32(1).
doi: 10.1053/hupa.2001.21135.

Interobserver reproducibility of Gleason grading of prostatic carcinoma: general pathologist

W C Allsbrook 1 K A Mangold  M H Johnson  R B Lane  C G Lane  J I Epstein  
  • PMID: 11172299
  •     89 citations


Only a few large studies of interobserver reproducibility of Gleason grading of prostatic carcinoma exist. Thirty-eight biopsies containing prostate cancer were distributed for Gleason grading to 41 general pathologists in Georgia. These cases had "consensus" Gleason grade groups (2-4, 5-6, 7, and 8-10) that were agreed on by at least 7 of 10 urologic pathologists. The overall kappa (kappa) coefficient for interobserver agreement for these 38 cases was 0.435, barely moderate agreement, with a kappa range from 0.00 to 0.88. There was consistent undergrading of Gleason scores 5-6 (47%), 7 (47%) and, to a lesser extent, 8-10 (25%). In cases with consensus primary patterns, there was consistent undergrading of patterns 2 (32%), 3 (39%), and 5 (30%). Pattern 2 was often (17%) mistaken for pattern 3. Pattern 4 was often undergraded (21%) and also mistaken for pattern 5 (17%). The most significant (P < .005) demographic factor associated with better interobserver agreement was having learned Gleason grading at a meeting or course. We believe that Gleason grading can be learned to a satisfactory level of interobserver reproducibility and have undertaken additional studies that support this belief.

The use of Raman spectroscopy to identify and grade prostatic adenocarcinoma in vitro.
P Crow, N Stone, +4 authors, M P J Wright.
Br J Cancer, 2003 Jul 03; 89(1). PMID: 12838309    Free PMC article.
Reproducibility of the 1998 World Health Organization/International Society of Urologic Pathology classification of papillary urothelial neoplasms of the urinary bladder.
Kutsal Yorukoglu, Burcin Tuna, +5 authors, Ziya Kirkali.
Virchows Arch, 2003 Oct 10; 443(6). PMID: 14534785
Interobserver reproducibility of modified Gleason score in radical prostatectomy specimens.
Axel Glaessgen, Hans Hamberg, +3 authors, Lars Egevad.
Virchows Arch, 2004 May 25; 445(1). PMID: 15156317
The use of Raman spectroscopy to differentiate between different prostatic adenocarcinoma cell lines.
P Crow, B Barrass, +4 authors, N Stone.
Br J Cancer, 2005 Jun 02; 92(12). PMID: 15928665    Free PMC article.
[Synovialitis score: histopathological grading system for chronic rheumatic and non-rheumatic synovialitis].
V Krenn, L Morawietz, G-R Burmester, T Häupl.
Z Rheumatol, 2005 Jun 21; 64(5). PMID: 15965818
Current practice of Gleason grading of prostate carcinoma.
Antonio Lopez-Beltran, Gregor Mikuz, +2 authors, Rodolfo Montironi.
Virchows Arch, 2005 Dec 06; 448(2). PMID: 16328356
[Low-grade-/high-grade-synovitis: synovitis-score as a gold standard?].
V Krenn, L Morawietz, +5 authors, T Häupl.
Orthopade, 2006 Jul 05; 35(8). PMID: 16819616
Duplication of the fusion of TMPRSS2 to ERG sequences identifies fatal human prostate cancer.
G Attard, J Clark, +14 authors, Transatlantic Prostate Group.
Oncogene, 2007 Jul 20; 27(3). PMID: 17637754    Free PMC article.
Highly Cited.
Reproducibility and reliability of tumor grading in urological neoplasms.
Rainer Engers.
World J Urol, 2007 Sep 11; 25(6). PMID: 17828603
Prostate cancer in male BRCA1 and BRCA2 mutation carriers has a more aggressive phenotype.
A Mitra, C Fisher, +10 authors, R Eeles.
Br J Cancer, 2008 Jan 10; 98(2). PMID: 18182994    Free PMC article.
Interobserver reproducibility of Gleason grading: evaluation using prostate cancer tissue microarrays.
M Burchardt, R Engers, +7 authors, M A Rubin.
J Cancer Res Clin Oncol, 2008 Apr 09; 134(10). PMID: 18392850
Pathological correlation between needle biopsy and radical prostatectomy specimen in patients with localized prostate cancer.
Muhammad A Bulbul, Yaser El-Hout, +4 authors, Oussama Darwish.
Can Urol Assoc J, 2008 Jun 11; 1(3). PMID: 18542801    Free PMC article.
Infrared micro-spectral imaging: distinction of tissue types in axillary lymph node histology.
Benjamin Bird, Milos Miljkovic, +4 authors, Max Diem.
BMC Clin Pathol, 2008 Sep 02; 8. PMID: 18759967    Free PMC article.
Prostate gland biopsies and prostatectomies: an Ontario community hospital experience.
Ken J Newell, John F Amrhein, +4 authors, Brian F Rudrick.
Can Urol Assoc J, 2008 Oct 28; 2(5). PMID: 18953449    Free PMC article.
Improving the reliability of diagnostic tests in population-based agreement studies.
Kerrie P Nelson, Don Edwards.
Stat Med, 2010 Feb 04; 29(6). PMID: 20128018    Free PMC article.
Clinical implications of changing definitions within the Gleason grading system.
Tamara L Lotan, Jonathan I Epstein.
Nat Rev Urol, 2010 Feb 17; 7(3). PMID: 20157302
Histopathological image analysis: a review.
Metin N Gurcan, Laura E Boucheron, +3 authors, B Yener.
IEEE Rev Biomed Eng, 2009 Jan 01; 2. PMID: 20671804    Free PMC article.
Highly Cited. Review.
Genome-wide association study of prostate cancer mortality.
Kathryn L Penney, Saumyadipta Pyne, +11 authors, Matthew L Freedman.
Cancer Epidemiol Biomarkers Prev, 2010 Oct 28; 19(11). PMID: 20978177    Free PMC article.
Interobserver variability in histologic evaluation of radical prostatectomy between central and local pathologists: findings of TAX 3501 multinational clinical trial.
George J Netto, Mario Eisenberger, Jonathan I Epstein, TAX 3501 Trial Investigators.
Urology, 2010 Dec 15; 77(5). PMID: 21146858    Free PMC article.
Current perspectives on Gleason grading of prostate cancer.
Kenneth A Iczkowski, M Scott Lucia.
Curr Urol Rep, 2011 Mar 23; 12(3). PMID: 21424766
Clinical significance of a large difference (≥ 2 points) between biopsy and post-prostatectomy pathological Gleason scores in patients with prostate cancer.
Changhee Yoo, Cheol Young Oh, +18 authors, Han Yong Choi.
J Korean Med Sci, 2011 Apr 07; 26(4). PMID: 21468257    Free PMC article.
Interactive digital slides with heat maps: a novel method to improve the reproducibility of Gleason grading.
Lars Egevad, Ferran Algaba, +15 authors, Philippe Camparo.
Virchows Arch, 2011 Jun 24; 459(2). PMID: 21698392
The value of second-opinion pathology diagnoses on prostate biopsies from patients referred for management of prostate cancer.
Al B Barqawi, Ruslan Turcanu, +5 authors, Francisco G La Rosa.
Int J Clin Exp Pathol, 2011 Jul 09; 4(5). PMID: 21738818    Free PMC article.
Computer-aided identification of prostatic adenocarcinoma: Segmentation of glandular structures.
Yahui Peng, Yulei Jiang, +3 authors, Ximing J Yang.
J Pathol Inform, 2011 Aug 17; 2. PMID: 21845231    Free PMC article.
High-grade prostatic adenocarcinoma present in a single biopsy core is associated with increased extraprostatic extension, seminal vesicle invasion, and positive surgical margins at prostatectomy.
Alcides Chaux, Daniel A Fajardo, +4 authors, George J Netto.
Urology, 2011 Dec 17; 79(4). PMID: 22173174    Free PMC article.
Improving the reproducibility of the Gleason scores in small foci of prostate cancer--suggestion of diagnostic criteria for glandular fusion.
B Helpap, G Kristiansen, +4 authors, Ch Fellbaum.
Pathol Oncol Res, 2011 Dec 20; 18(3). PMID: 22179685
Molecular preservation by extraction and fixation, mPREF: a method for small molecule biomarker analysis and histology on exactly the same tissue.
Jeffrey R Shuster, Raymond S Lance, Dean A Troyer.
BMC Clin Pathol, 2011 Dec 23; 11. PMID: 22188997    Free PMC article.
Frequency and determinants of disagreement and error in gleason scores: a population-based study of prostate cancer.
Michael Goodman, Kevin C Ward, +8 authors, Mahul B Amin.
Prostate, 2012 Jan 10; 72(13). PMID: 22228120    Free PMC article.
Cascaded discrimination of normal, abnormal, and confounder classes in histopathology: Gleason grading of prostate cancer.
Scott Doyle, Michael D Feldman, +2 authors, Anant Madabhushi.
BMC Bioinformatics, 2012 Nov 01; 13. PMID: 23110677    Free PMC article.
Gleason grading of prostate cancer in needle core biopsies: a comparison of general and urologic pathologists.
Jaudah Ahmed Al-Maghrabi, Nasir A Bakshi, Hasan M A Farsi.
Ann Saudi Med, 2013 Mar 06; 33(1). PMID: 23458939    Free PMC article.
Gleason scoring at a comprehensive cancer center: what's the difference?
Natasha C Townsend, Karen Ruth, +5 authors, Mark K Buyyounouski.
J Natl Compr Canc Netw, 2013 Jul 13; 11(7). PMID: 23847218    Free PMC article.
Explicit shape descriptors: novel morphologic features for histopathology classification.
Rachel Sparks, Anant Madabhushi.
Med Image Anal, 2013 Jul 16; 17(8). PMID: 23850744    Free PMC article.
Statistical Shape Model for Manifold Regularization: Gleason grading of prostate histology.
Rachel Sparks, Anant Madabhushi.
Comput Vis Image Underst, 2013 Jul 28; 117(9). PMID: 23888106    Free PMC article.
Diagnostic segregation of human brain tumours using Fourier-transform infrared and/or Raman spectroscopy coupled with discriminant analysis.
Ketan Gajjar, Lara D Heppenstall, +8 authors, Francis L Martin.
Anal Methods, 2013 Oct 08; 5. PMID: 24098310    Free PMC article.
Segmentation of epidermal tissue with histopathological damage in images of haematoxylin and eosin stained human skin.
Juliana M Haggerty, Xiao N Wang, +2 authors, Elaine B Martin.
BMC Med Imaging, 2014 Feb 14; 14. PMID: 24521154    Free PMC article.
Co-occurring gland angularity in localized subgraphs: predicting biochemical recurrence in intermediate-risk prostate cancer patients.
George Lee, Rachel Sparks, +6 authors, Anant Madabhushi.
PLoS One, 2014 May 31; 9(5). PMID: 24875018    Free PMC article.
Advantages of evaluating mean nuclear volume as an adjunct parameter in prostate cancer.
Eduardo Leze, Clarice F E Maciel-Osorio, Carlos A Mandarim-de-Lacerda.
PLoS One, 2014 Jul 10; 9(7). PMID: 25007252    Free PMC article.
Subspecialty surgical pathologist's performances as triage pathologists on a telepathology-enabled quality assurance surgical pathology service: A human factors study.
Beth L Braunhut, Anna R Graham, +4 authors, Ronald S Weinstein.
J Pathol Inform, 2014 Jul 25; 5(1). PMID: 25057432    Free PMC article.
Should active surveillance in prostate cancer patients be based on a single histological assessment?
Lukasz Nyk, Tomasz Golabek, +5 authors, Andrzej Borówka.
Cent European J Urol, 2014 Sep 24; 67(3). PMID: 25247080    Free PMC article.
Near-infrared fluorescent digital pathology for the automation of disease diagnosis and biomarker assessment.
Summer L Gibbs, Elizabeth Genega, +7 authors, John V Frangioni.
Mol Imaging, 2015 Mar 31; 14. PMID: 25812603    Free PMC article.
How bioinformatics influences health informatics: usage of biomolecular sequences, expression profiles and automated microscopic image analyses for clinical needs and public health.
Vladimir Kuznetsov, Hwee Kuan Lee, +4 authors, Frank Eisenhaber.
Health Inf Sci Syst, 2013 Jan 01; 1. PMID: 25825654    Free PMC article.
Extracting knowledge from chemical imaging data using computational algorithms for digital cancer diagnosis.
Saumya Tiwari, Rohit Bhargava.
Yale J Biol Med, 2015 Jun 02; 88(2). PMID: 26029012    Free PMC article.
Identifying in vivo DCE MRI markers associated with microvessel architecture and gleason grades of prostate cancer.
Asha Singanamalli, Mirabela Rusu, +7 authors, Anant Madabhushi.
J Magn Reson Imaging, 2015 Jun 26; 43(1). PMID: 26110513    Free PMC article.
Machine learning approaches to analyze histological images of tissues from radical prostatectomies.
Arkadiusz Gertych, Nathan Ing, +7 authors, Beatrice S Knudsen.
Comput Med Imaging Graph, 2015 Sep 13; 46 Pt 2. PMID: 26362074    Free PMC article.
Pathological upgrading in prostate cancer patients eligible for active surveillance: Does prostate-specific antigen density matter?
Byung-Soo Jin, Seok-Hyun Kang, +5 authors, Jae-Shin Park.
Korean J Urol, 2015 Sep 15; 56(9). PMID: 26366274    Free PMC article.
Gleason grading challenges in the diagnosis of prostate adenocarcinoma: experience of a single institution.
Sonja D Chen, Joseph L Fava, Ali Amin.
Virchows Arch, 2015 Nov 14; 468(2). PMID: 26563400
Clinical Validation of the 2005 ISUP Gleason Grading System in a Cohort of Intermediate and High Risk Men Undergoing Radical Prostatectomy.
Sheila F Faraj, Stephania M Bezerra, +12 authors, George J Netto.
PLoS One, 2016 Jan 06; 11(1). PMID: 26731672    Free PMC article.
The Quantitative Criteria Based on the Fractal Dimensions, Entropy, and Lacunarity for the Spatial Distribution of Cancer Cell Nuclei Enable Identification of Low or High Aggressive Prostate Carcinomas.
Przemyslaw Waliszewski.
Front Physiol, 2016 Feb 24; 7. PMID: 26903883    Free PMC article.
Perineural invasion status, Gleason score and number of positive cores in biopsy pathology are predictors of positive surgical margin following laparoscopic radical prostatectomy.
Rong Yang, Kai Cao, +6 authors, Hong-Qian Guo.
Asian J Androl, 2016 Mar 24; 19(4). PMID: 27004537    Free PMC article.
A measure of association for ordered categorical data in population-based studies.
Kerrie P Nelson, Don Edwards.
Stat Methods Med Res, 2016 May 18; 27(3). PMID: 27184590    Free PMC article.
Out-of-Sample Extrapolation utilizing Semi-Supervised Manifold Learning (OSE-SSL): Content Based Image Retrieval for Histopathology Images.
Rachel Sparks, Anant Madabhushi.
Sci Rep, 2016 Jun 07; 6. PMID: 27264985    Free PMC article.
Salvage radiation therapy 11 years after a radical prostatectomy.
Valérie Hogues, Carole Lambert, Michael McCormack.
Can Urol Assoc J, 2016 Oct 30; 10(5-6). PMID: 27790303    Free PMC article.
Volumetry of the dominant intraprostatic tumour lesion: intersequence and interobserver differences on multiparametric MRI.
Hugh Harvey, Matthew R Orton, +4 authors, Nandita M deSouza.
Br J Radiol, 2017 Jan 06; 90(1071). PMID: 28055249    Free PMC article.
Gland segmentation in prostate histopathological images.
Malay Singh, Emarene Mationg Kalaw, +3 authors, Hwee Kuan Lee.
J Med Imaging (Bellingham), 2017 Jun 28; 4(2). PMID: 28653016    Free PMC article.
Pre-diagnostic metabolite concentrations and prostate cancer risk in 1077 cases and 1077 matched controls in the European Prospective Investigation into Cancer and Nutrition.
Julie A Schmidt, Georgina K Fensom, +33 authors, Ruth C Travis.
BMC Med, 2017 Jul 06; 15(1). PMID: 28676103    Free PMC article.
Prognostic Value of the New Prostate Cancer International Society of Urological Pathology Grade Groups.
Anne Offermann, Silke Hohensteiner, +11 authors, Sven Perner.
Front Med (Lausanne), 2017 Oct 17; 4. PMID: 29034236    Free PMC article.
Modeling rater diagnostic skills in binary classification processes.
Xiaoyan Lin, Hua Chen, Don Edwards, Kerrie P Nelson.
Stat Med, 2017 Nov 03; 37(4). PMID: 29094378    Free PMC article.
On cribriform prostate cancer.
Charlotte F Kweldam, Theodorus van der Kwast, Geert J van Leenders.
Transl Androl Urol, 2018 Mar 30; 7(1). PMID: 29594028    Free PMC article.
Quantitative nuclear histomorphometry predicts oncotype DX risk categories for early stage ER+ breast cancer.
Jon Whitney, German Corredor, +6 authors, Anant Madabhushi.
BMC Cancer, 2018 Jun 01; 18(1). PMID: 29848291    Free PMC article.
A Multi-scale U-Net for Semantic Segmentation of Histological Images from Radical Prostatectomies.
Jiayun Li, Karthik V Sarma, +3 authors, Corey W Arnold.
AMIA Annu Symp Proc, 2018 Jun 02; 2017. PMID: 29854182    Free PMC article.
Digital pathology image analysis: opportunities and challenges.
Anant Madabhushi.
Imaging Med, 2009 Jan 01; 1(1). PMID: 30147749    Free PMC article.
Identifying the morphologic basis for radiomic features in distinguishing different Gleason grades of prostate cancer on MRI: Preliminary findings.
Gregory Penzias, Asha Singanamalli, +13 authors, Anant Madabhushi.
PLoS One, 2018 Sep 01; 13(8). PMID: 30169514    Free PMC article.
Systematic identification of mutations and copy number alterations associated with cancer patient prognosis.
Joan C Smith, Jason M Sheltzer.
Elife, 2018 Dec 12; 7. PMID: 30526857    Free PMC article.
Development and validation of a deep learning algorithm for improving Gleason scoring of prostate cancer.
Kunal Nagpal, Davis Foote, +16 authors, Martin C Stumpe.
NPJ Digit Med, 2019 Jul 16; 2. PMID: 31304394    Free PMC article.
Highly Cited.
Developing a National Center of Excellence for Prostate Imaging.
Annerleim Walton-Diaz, Manuel Madariaga-Venegas, +3 authors, Mauricio Burotto.
Curr Urol Rep, 2019 Sep 04; 20(10). PMID: 31478111
Statistical Analysis of Survival Models Using Feature Quantification on Prostate Cancer Histopathological Images.
Jian Ren, Eric A Singer, +2 authors, Xin Qi.
J Pathol Inform, 2019 Oct 18; 10. PMID: 31620309    Free PMC article.
Measurement of Prostate Volume with MRI (A Guide for the Perplexed): Biproximate Method with Analysis of Precision and Accuracy.
Neil F Wasserman, Eric Niendorf, Benjamin Spilseth.
Sci Rep, 2020 Jan 19; 10(1). PMID: 31953425    Free PMC article.
Automated Gleason Scoring and Tumor Quantification in Prostate Core Needle Biopsy Images Using Deep Neural Networks and Its Comparison with Pathologist-Based Assessment.
Han Suk Ryu, Min-Sun Jin, +10 authors, Hyeyoon Chang.
Cancers (Basel), 2019 Nov 27; 11(12). PMID: 31769420    Free PMC article.
Multi-objective Parameter Auto-tuning for Tissue Image Segmentation Workflows.
Luis F R Taveira, Tahsin Kurc, +4 authors, George Teodoro.
J Digit Imaging, 2018 Nov 08; 32(3). PMID: 30402669    Free PMC article.
Comparison of Artificial Intelligence Techniques to Evaluate Performance of a Classifier for Automatic Grading of Prostate Cancer From Digitized Histopathologic Images.
Guy Nir, Davood Karimi, +9 authors, Septimiu E Salcudean.
JAMA Netw Open, 2019 Mar 09; 2(3). PMID: 30848813    Free PMC article.
Precise Identification of Cell and Tissue Features Important for Histopathologic Diagnosis by a Whole Slide Imaging System.
Thomas W Bauer, Cynthia Behling, +6 authors, Jinsong Qiu.
J Pathol Inform, 2020 Mar 11; 11. PMID: 32154040    Free PMC article.
Development of a Deep Learning Algorithm for the Histopathologic Diagnosis and Gleason Grading of Prostate Cancer Biopsies: A Pilot Study.
Ohad Kott, Drew Linsley, +5 authors, Boris Gershman.
Eur Urol Focus, 2019 Nov 27; 7(2). PMID: 31767543    Free PMC article.
Development and Validation of a Deep Learning Algorithm for Gleason Grading of Prostate Cancer From Biopsy Specimens.
Kunal Nagpal, Davis Foote, +23 authors, Craig H Mermel.
JAMA Oncol, 2020 Jul 24; 6(9). PMID: 32701148    Free PMC article.
Deep learning with noisy labels: Exploring techniques and remedies in medical image analysis.
Davood Karimi, Haoran Dou, Simon K Warfield, Ali Gholipour.
Med Image Anal, 2020 Jul 06; 65. PMID: 32623277    Free PMC article.
Radio-pathomic mapping model generated using annotations from five pathologists reliably distinguishes high-grade prostate cancer.
Sean D McGarry, John D Bukowy, +17 authors, Peter S LaViolette.
J Med Imaging (Bellingham), 2020 Sep 15; 7(5). PMID: 32923510    Free PMC article.
Interpathologist Diagnostic Agreement for Non-Small Cell Lung Carcinomas Using Current and Recent Classifications.
William K Funkhouser, D Neil Hayes, +27 authors, Philip T Cagle.
Arch Pathol Lab Med, 2018 May 01; 142(12). PMID: 29708428    Free PMC article.
Identification of areas of grading difficulties in prostate cancer and comparison with artificial intelligence assisted grading.
Lars Egevad, Daniela Swanberg, +23 authors, Martin Eklund.
Virchows Arch, 2020 Jun 17; 477(6). PMID: 32542445    Free PMC article.
Histopathology of Prostate Cancer.
Peter A Humphrey.
Cold Spring Harb Perspect Med, 2017 Apr 09; 7(10). PMID: 28389514    Free PMC article.
Refining the risk-stratification of transrectal biopsy-detected prostate cancer by elastic fusion registration transperineal biopsies.
Bertrand Covin, Mathieu Roumiguié, +6 authors, Bernard Malavaud.
World J Urol, 2018 Aug 27; 37(2). PMID: 30145777
Artificial intelligence at the intersection of pathology and radiology in prostate cancer.
Stephnie A Harmon, Sena Tuncer, +2 authors, Barış Türkbey.
Diagn Interv Radiol, 2019 May 08; 25(3). PMID: 31063138    Free PMC article.
Automated Gleason grading of prostate cancer using transfer learning from general-purpose deep-learning networks.
Mircea Sebastian Şerbănescu, Nicolae Cătălin Manea, +5 authors, Răzvan Mihail Pleşea.
Rom J Morphol Embryol, 2020 Aug 05; 61(1). PMID: 32747906    Free PMC article.
Prostate cancer growth patterns beyond the Gleason score: entering a new era of comprehensive tumour grading.
Geert J L H van Leenders, Esther I Verhoef, Eva Hollemans.
Histopathology, 2020 Jul 20; 77(6). PMID: 32683729    Free PMC article.
Utility of Pathology Imagebase for standardisation of prostate cancer grading.
Lars Egevad, Brett Delahunt, +25 authors, Mark Clements.
Histopathology, 2018 Jan 24; 73(1). PMID: 29359484    Free PMC article.
Interchangeability of light and virtual microscopy for histopathological evaluation of prostate cancer.
Renata Zelic, Francesca Giunchi, +12 authors, Andreas Pettersson.
Sci Rep, 2021 Feb 07; 11(1). PMID: 33547336    Free PMC article.
Agreement of two pre-trained deep-learning neural networks built with transfer learning with six pathologists on 6000 patches of prostate cancer from Gleason2019 Challenge.
Mircea Sebastian Şerbănescu, Carmen Nicoleta Oancea, +4 authors, Răzvan Mihail Pleşea.
Rom J Morphol Embryol, 2021 Feb 06; 61(2). PMID: 33544803    Free PMC article.
All change in the prostate cancer diagnostic pathway.
Derek J Lomas, Hashim U Ahmed.
Nat Rev Clin Oncol, 2020 Mar 01; 17(6). PMID: 32112055
Artificial intelligence assistance significantly improves Gleason grading of prostate biopsies by pathologists.
Wouter Bulten, Maschenka Balkenhol, +20 authors, Geert Litjens.
Mod Pathol, 2020 Aug 08; 34(3). PMID: 32759979    Free PMC article.
Inter-observer variability of cribriform architecture and percent Gleason pattern 4 in prostate cancer: relation to clinical outcome.
Margaretha A van der Slot, Eva Hollemans, +5 authors, Geert J L H van Leenders.
Virchows Arch, 2020 Aug 21; 478(2). PMID: 32815034    Free PMC article.
First approach to distinguish between cardiac and arteriosclerotic emboli of individual stroke patients applying the histological THROMBEX-classification rule.
Florian C Roessler, Nicolas Kalms, +6 authors, Georg Royl.
Sci Rep, 2021 Apr 21; 11(1). PMID: 33875717    Free PMC article.