Telepathology consultation for frozen section diagnosis in China
Telepathology consultation for frozen section diagnosis in China
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DOI：
10.1186/s13000-018-0705-0
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发表时间：
2018-05-14
影响因子：
2.6
通讯作者：
Deng, Yongjian
中科院分区：
文献类型：
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作者：
Huang, Yingxin;Lei, Yan;Deng, Yongjian
背景资料：远程病理学（TP）为初级诊断实践提供远程病理学服务，包括手术病理学的术中咨询;在中国尚未广泛实施。方法：利用南方医科大学-广州华银医学检验中心（SMU-HUAYIN TP）的TP会诊平台，连接71家参与的基层医院和11位资深病理医师，对术中冰冻切片的诊断进行了为期2年半的实践。南方医院是一家位于中国大城市的高水平医院。本回顾性研究通过比较2015年1月至2017年6月2.5年间平台和南方医院的数据，总结TP用于冰冻切片诊断的经验和结果。结果：平台共收到5233起案件，其中2015年1019起，2016年2320起，2017年1894起。乳腺癌最常见（30.42%），其次为甲状腺癌（29.05%）和妇科癌（24.86%）。2015年和2016年平台病例平均周转时间（达特）控制在30 min以内，绝大多数W病例（90.31%）和南方医院病例（86.14%）均提供了明确诊断。TP病例符合率为99.77%，南方医院病例符合率为99.35%。W病例的假阳性率和假阴性率分别为0.04%和0.19%，不同级别的病理医师间的假阳性率和假阴性率差异无统计学意义（P = 0.974，P = 0.989，P > 0.05）。W例与南方医院同一位资深病理医师诊断的病例之间差异无统计学意义（P > 0.05）。结论：TP在冰冻切片诊断中的应用可以改善患者护理，解决我国病理资源分布不均的问题。我们相信，在不久的将来，冰冻切片诊断中的TP将成为远程医疗的重要组成部分，并将在中国的医疗改革中发挥重要作用。
Background: Telepathology (TP) provides remote pathology services for primary diagnosis practices, including intraoperative consultation of surgical pathology; it has not been widely implemented in China. In this study, the results of an implementation were reported, which lasted for two and a half years, and demonstrated the experience of the diagnosis of the intraoperative frozen sections by using TP consultation platform of Southern Medical University and Guangzhou Huayin Medical Laboratory Center (SMU-HUAYIN TP) in China.Methods: The SMU-HUAYIN TP consultation platform connects 71 participating basic hospitals and 11 senior pathologists. Nanfang Hospital is a high-level hospital located in a large city in China. This retrospective study summarizes the experience and results of TP for frozen section diagnosis by comparing the data of the platform and Nanfang Hospital over a period of 2.5 years from January 2015 to June 2017.Results: A total of 5233 cases were submitted to the platform, including 1019 cases in 2015, 2320 cases in 2016, and 1894 cases in 2017. The most common cases were breast (30.42%), followed by thyroid (29.05%) and gynecological (24.86%). Average turn-around time (TAT) of the cases from the platform in 2015 and 2016 was controlled within 30 min. In most W cases (90.31%) and cases from Nanfang Hospital (86.14%), a definitive diagnosis was provided. The coincidence rate was 99.77% in the TP cases and 99.35% in the cases from Nanfang Hospital. The false positive and false negative rates of W cases were 0.04 and 0.19%, respectively and no significant difference was found among different senior pathologists (P = 0.974, P = 0.989, P > 0.05). Similarly, there was no significant difference between W cases and cases from Nanfang Hospital that were diagnosed by the same senior pathologist (P > 0.05).Conclusions: Our results indicate that TP in frozen section diagnosis could improve patient care and solve the problem of unevenly distributed pathology resources in China. We believe that in the near future, TP in frozen section diagnosis will become an important component of telemedicine and will play a significant role in health care reform in China.