Colorectal cancer pathology reporting: A regional audit
Colorectal cancer pathology reporting: A regional audit
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DOI：
10.1136/jcp.50.2.138
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发表时间：
1997-02-01
影响因子：
3.4
通讯作者：
Williams, GT
中科院分区：
文献类型：
--
作者：
Bull, AD;Biffin, AHB;Williams, GT
目的-审计一个国家卫生服务地区结直肠癌标本的病理报告的信息内容。方法-1993年来自威尔士17个NHS组织病理学实验室的所有结直肠癌切除标本的报告都按照以下标准进行评估：(A)威尔士病理学家先前同意的标准；以及(B)被认为是知情患者管理的最低要求的标准。结果-1242份报告被审计。不同实验室的表现和个别信息报告的完整性存在着显着差异。虽然许多项目总体上都得到了很好的报道，但只有51.5%(640/1242)的直肠癌报告包含了关于环切切缘切除是否完整的声明，只有30%(373/1242)的报告说明了受累淋巴结的数量。所有先前商定的项目仅包含在11.3%(140/1242)的结肠肿瘤报告和4.0%(40/1242)的直肠肿瘤报告中。78%(969/1242)的结肠癌报告和46.6%(579/1242)的直肠癌报告符合最低标准。结论：许多常规病理报告中有关结直肠癌切除标本的信息内容不足以满足高质量的患者管理、通过审计确保临床有效的癌症服务和癌症登记。建议使用国家商定的标准进行模板形式报告作为补救措施，同时改进教育，根据当前知识审查实验室实践，并通过参与多学科癌症管理团队进一步激励病理学家。
Aims-To audit the information content of pathology reports of colorectal cancer specimens in one National Health Service region.Methods-All reports of colorectal cancer resection specimens from the 17 NHS histopathology laboratories in Wales during 1993 were evaluated against: (a) standards previously agreed as desirable by pathologists in Wales; and (b) standards considered to be the minimum required for informed patient management.Results-1242 reports were audited. There was notable variation in the performance of different laboratories and in the completeness of reporting of individual items of information. While many items were generally well reported, only 51.5% (640/1242) of rectal cancer reports contained a statement on the completeness of excision at the circumferential resection margin and only 30% (373/1242) of all reports stated the number of involved lymph nodes. All of the previously agreed items were contained in only 11.3% (140/1242) of reports on colonic tumours and 4.0% (40/1242) of reports on rectal tumours. Seventy eight per cent (969/1242) of colonic carcinoma reports and 46.6% (579/1242) of rectal carcinoma reports met the minimum standards.Conclusions-The informational content of many routine pathology reports on colorectal cancer resection specimens is inadequate for quality patient management, for ensuring a clinically effective cancer service through audit, and for cancer registration. Template proforma reporting using nationally agreed standards is recommended as a remedy for this, along with improved education, review of laboratory practices in the light of current knowledge, and further motivation of pathologists through their involvement in multidisciplinary cancer management teams.