Validation of whole slide imaging in the primary diagnosis of gynaecological pathology in a University Hospital
Validation of whole slide imaging in the primary diagnosis of gynaecological pathology in a University Hospital
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DOI：
10.1136/jclinpath-2014-202524
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发表时间：
2015-01-01
影响因子：
3.4
通讯作者：
Ramirez, Jose
中科院分区：
文献类型：
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作者：
Ordi, Jaume;Castillo, Paola;Ramirez, Jose
在病理学中使用全切片成像（WSI）进行初步诊断的经验非常有限。我们的目的是确定WSI的解释的准确性与传统的光学显微镜（CLM）在常规gynaecological biopsizes.Methods的诊断所有妇科标本（n=452）收到了超过2个月的时间在巴塞罗那的医院诊所病理科进行了盲分析，由两名妇科病理学家，一个使用CLM和其他WSI。所有载玻片均在Ventana iScan HT（Roche diagnostics）中以200 x进行数字化。对所有不一致的诊断进行了审查，并建立了最终的共识诊断。结果采用加权法进行评价。结果WSI和CLM评估之间的观察者间一致性水平几乎是完美的（Kappa值：0.914; 95%CI 0.879至0.949），并在研究期间增加：。第一阶段为0.890; 95% CI 0.835 - 0.945，第二阶段为0.941; 95% CI 0.899 - 0.983。在9例（2.0%）病例中观察到重大差异（临床管理或预后差异）。所有差异包括WSI或CLM评价中诊断不足或漏诊的小病变（8例宫颈高度鳞状上皮内病变，1例卵巢癌淋巴结微转移）。在3.8%的活检中发现了无临床相关性或临床相关性较小的不确定性。结论WSI对妇科标本的诊断准确，可作为妇科常规诊断的一种方法。
Aims Experience in the use of whole slide imaging (WSI) for primary diagnosis in pathology is very limited. We aimed to determine the accuracy of interpretation of WSI compared with conventional light microscopy (CLM) in the diagnosis of routine gynaecological biopsies.Methods All gynaecological specimens (n=452) received over a 2-month period at the Department of Pathology of the Hospital Clinic of Barcelona were analysed blindly by two gynaecological pathologists, one using CLM and the other WSI. All slides were digitised in a Ventana iScan HT (Roche diagnostics) at 200x. All discrepant diagnoses were reviewed, and a final consensus diagnosis was established. The results were evaluated by weighted. statistics for two observers.Results The level of interobserver agreement between WSI and CLM evaluations was almost perfect (kappa value: 0.914; 95% CI 0.879 to 0.949) and increased during the study period:. value 0.890; 95% CI 0.835 to 0.945 in the first period and 0.941; 95%; CI 0.899 to 0.983 in the second period. Major discrepancies (differences in clinical management or prognosis) were observed in 9 cases (2.0%). All discrepancies consisted of small lesions (8 high grade squamous intraepithelial lesions of the uterine cervix, one lymph node micrometastasis of an ovarian carcinoma) underdiagnosed or missed in the WSI or the CLM evaluation. Discrepancies with no or minor clinical relevance were identified in 3.8% of the biopsies. No discrepancy was related to the poor quality of the WSI image.Conclusions Diagnosis of gynaecological specimens by WSI is accurate and may be introduced into routine diagnosis.