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The results of a comparison of cases with and without PWDA among T1 cancers are shown in Table 4.
Among the 73 PWDA cases, 44 without lymphatic or venous invasion had no LNM and 29 with lymphatic or venous invasion had no LNM (Table 5).
With respect to histological agreement concerning PWDA, the kappa values for the intraobserver agreement of the 2 pathologists were 0.612 and 0.681, while that for the inter-observer agreement concerning PWDA was 0.596.
The rate of lymphatic or venous invasion was 63.9%, and there were no PWDA cases among the 72 T1 cancers with LNM.
When PWDA was adopted as a safe factor, none of the 58 patients with PWDA had LNM.
In the current study, we showed that T2 cancer patients with PWDA had a lower rate of LNM (4.3%) than those without PDWA (28.3%) and a better prognosis as well.
These findings prove that PWDA is a novel histological safe factor for LNM and indicate a better prognosis in T2 cancer patients.
PWDA is deemed an even safer factor than this because it was found to be a safe factor even in cases with lymphatic or venous invasion.
For the diagnosis of PWDA, the kappa values for the intra- and interobserver agreement of the 2 pathologists were not high enough (0.596-0.681) though this study was performed only in one center.
In addition, the number of T1 cancer cases with LNM was insufficient to prove PWDA was a safe factor for LNM.
Our pilot study showed that PWDA is a safe factor for predicting LNM in T1 cancers.
Caption: Figure 1: Case presentation of pure well-differentiated adenocarcinoma (PWDA).
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