Lymph node harvests directly influence the staging of colorectal cancer: evidence from a regional audit
Lymph node harvests directly influence the staging of colorectal cancer: evidence from a regional audit
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DOI：
10.1136/jcp.57.1.43
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发表时间：
2004-01-01
影响因子：
3.4
通讯作者：
Shepherd, NA
中科院分区：
文献类型：
--
作者：
Pheby, DFH;Levine, DF;Shepherd, NA
目的：评估前西南卫生区结直肠癌组织病理学报告的质量和Dukes分期的准确性，并确定检查的淋巴结数量对分期的影响。方法：分析1993 - 7年结直肠癌组织病理学报告。根据报告的检查淋巴结数量、阳性数量、Dukes分期和ICD 9代码评估完整性。记录检查的淋巴结数量、阳性数量和Dukes分期。结果从一家医院已知有高标准的报告进行了比较，从其他地方。结果：总共有629份报告进行了检查，从参考医院和918从其他地方。来自参考医院的报告中不到20分之一（4.3%）是不完整的，而其他地方的报告中有三分之一（36.1%）是不完整的。参考医院每例病例检查的平均淋巴结数量为18.81个，其他地方为6.41个。每个病例的平均阳性淋巴结数量在参考医院为2.47，在其他地方为1.15。杜克斯的C期病例的比例在参考医院明显高于其他地方。杜克斯C期病例的确定与淋巴结检查的数量有关，当至少10个和少于15个淋巴结检查时，最佳确定水平为：组织病理学报告的标准，以及杜克斯C期的确定，在参考医院显着较高。Dukes C期疾病的确定水平的变化主要是由于检查的淋巴结数量的变化。
Aims: To assess the quality of histopathology reporting and accuracy of Dukes's staging of colorectal cancers in the former South Western Health region and to determine the impact of numbers of lymph nodes examined on stage ascription.Methods: Histopathology reports of colorectal cancer for 1993 - 7 were analysed. Completeness was assessed regarding reported numbers of lymph nodes examined, numbers found positive, Dukes's stage, and ICD9 code. Numbers of lymph nodes examined, numbers found positive, and Dukes's stage were recorded. Results from one hospital known to have high standards of reporting were compared with those from elsewhere.Results: In total, 629 reports were examined from the reference hospital and 918 from elsewhere. Fewer than one in 20 (4.3%) reports from the reference hospital were incomplete, compared with a third (36.1%) elsewhere. The average number of nodes examined for each case at the reference hospital was 18.81 and 6.41 elsewhere. The average number of positive nodes for each case was 2.47 at the reference hospital and 1.15 elsewhere. The proportion of Dukes's stage C cases was significantly higher at the reference hospital than elsewhere. Ascertainment of Dukes's stage C cases was related to number of lymph nodes examined, with optimal ascertainment levels when at least 10 and fewer than 15 nodes were examined.Conclusions: Standards of histopathology reporting, and ascertainment of Dukes's stage C, were significantly higher at the reference hospital. Variations in ascertainment levels of Dukes's stage C disease mainly resulted from variations in the numbers of lymph nodes examined.