Innovative Synoptic Reporting With Seven-Point Sampling Protocol to Improve Detection Rate of Microvascular Invasion in Hepatocellular Carcinoma.
Innovative Synoptic Reporting With Seven-Point Sampling Protocol to Improve Detection Rate of Microvascular Invasion in Hepatocellular Carcinoma.
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DOI：
10.3389/fonc.2021.726239
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发表时间：
2021
影响因子：
4.7
通讯作者：
Kuang M
中科院分区：
文献类型：
--
作者：
Liao B;Liu L;Wei L;Wang Y;Chen L;Cao Q;Zhou Q;Xiao H;Chen S;Peng S;Li S;Kuang M
病理MVI诊断有助于判断肝细胞癌（HCC）的预后和是否需要辅助治疗。然而，叙述性报告（NR）会遗漏相关临床信息，非标准化采样会低估MVI检测。我们的目的是探讨创新的概要报告（SR）和七点采样（SPRING）协议对微血管浸润（MVI）率和患者结局的影响。在回顾性队列中，我们从三个中心的NR中提取了MVI状态，并在我们的中心通过美国病理学家学会（CAP）推荐的SR重新审查了标本切片。在前瞻性队列中，本中心实施SPRING方案，外部中心仍保留传统病理检查。在两个队列中，比较了本中心和外部中心的MVI率。采用Kaplan-Meier法计算实施前后的无复发生存期（RFS），并进行log-rank检验。在回顾性研究中，我们发现本中心和外部中心的MVI率无显著差异[10.3%（115/1112）vs. 12.4%（35/282），P=0.316]。在我们中心，CAP推荐的SR将MVI检出率从10.3%提高到38.6%（P<0.001）。在前瞻性研究中，本中心SPRING下的MVI率显著高于外部中心（53.2vs.17%，P<0.001）。在我们中心，SPRING后MVI（-）患者的RFS有所改善（P=0.010），但MVI（+）患者的RFS保持不变（P=0.200）。我们认为CAP推荐的SR有助于提高MVI的检出率。我们的SPRING方案有助于进一步提高MVI率，优化HCC患者的预后分层。
Pathological MVI diagnosis could help to determine the prognosis and need for adjuvant therapy in hepatocellular carcinoma (HCC). However, narrative reporting (NR) would miss relevant clinical information and non-standardized sampling would underestimate MVI detection. Our objective was to explore the impact of innovative synoptic reporting (SR) and seven-point sampling (SPRING) protocol on microvascular invasion (MVI) rate and patient outcomes. In retrospective cohort, we extracted MVI status from NR in three centers and re-reviewed specimen sections by SR recommended by the College of American Pathologists (CAP) in our center. In prospective cohort, our center implemented the SPRING protocol, and external centers remained traditional pathological examination. MVI rate was compared between our center and external centers in both cohorts. Recurrence-free survival (RFS) before and after implementation was calculated by Kaplan-Meier method and compared by the log-rank test. In retrospective study, we found there was no significant difference in MVI rate between our center and external centers [10.3% (115/1112) vs. 12.4% (35/282), P=0.316]. In our center, SR recommended by CAP improved the MVI detection rate from 10.3 to 38.6% (P<0.001). In prospective study, the MVI rate in our center under SPRING was significantly higher than external centers (53.2 vs. 17%, P<0.001). RFS of MVI (−) patients improved after SPRING in our center (P=0.010), but it remained unchanged in MVI (+) patients (P=0.200). We conclude that the SR recommended by CAP could help to improve MVI detection rate. Our SPRING protocol could help to further improve the MVI rate and optimize prognostic stratification for HCC patients.
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影响因子：
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作者：
Verbeke, Caroline Sophie;Gladhaug, Ivar Prydz
通讯作者：
Gladhaug, Ivar Prydz
影响因子：
25.7
作者：
Chatelain, Denis;Farges, Olivier;Regimbeau, Jean-Marc
通讯作者：
Regimbeau, Jean-Marc
影响因子：
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作者：
Srigley, John;Lankshear, Sara;Sawka, Carol
通讯作者：
Sawka, Carol
影响因子：
254.7
作者：
Raab, Stephen S.;Grzybicki, Dana M.
通讯作者：
Grzybicki, Dana M.
基于微血管侵犯的新型预后列线图可预测肝细胞癌 R0 切除后患者的生存结果
DOI：
10.1007/s00432-016-2286-1
发表时间：
2017-02-01
影响因子：
3.6
作者：
Feng, Long-Hai;Dong, Hui;Cong, Wen-Ming
通讯作者：
Cong, Wen-Ming