Reid M M, Roald B
Department of Haematology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
J Clin Pathol. 1999 Nov;52(11):851-2. doi: 10.1136/jcp.52.11.851.
To complete an audit of bone marrow trephine biopsy adequacy in children
605 specimens from children with neuroblastoma submitted by 25 centres were reviewed centrally. This reassessment ran between January 1995 and August 1998.
25% of specimens (95% confidence interval (CI) 21% to 29%) were inadequate compared with 17% (95% CI 14% to 20%) in a previous study. Variation between individual centres' performance remains high (5-54% of specimens inadequate). Had five centres performed as well as previously, the inadequate biopsy rate would have been unchanged from that found in the previous study. There was no important improvement in any centre's performance. Earlier suggestions about change in practice have had no discernible impact on centres' ability to obtain adequate bone marrow trephine biopsies from children.
The responsibility for improving the rate of adequate biopsies lies with individual centres. Reporting pathologists might help by making even more positive attempts to influence operators within their own centres.
完成一项关于儿童骨髓活检充分性的审计
对25个中心提交的605份神经母细胞瘤患儿的标本进行集中审查。此次重新评估于1995年1月至1998年8月期间进行。
与之前一项研究中17%（95%置信区间（CI）14%至20%）相比，25%的标本（95% CI 21%至29%）不充分。各中心之间的表现差异仍然很大（5%至54%的标本不充分）。如果有五个中心的表现与之前一样好，活检不充分率将与之前研究中的结果没有变化。任何一个中心的表现都没有显著改善。先前关于改变操作的建议对各中心从儿童获取充分骨髓活检的能力没有明显影响。
提高活检充分率的责任在于各个中心。报告病理学家可以通过更积极地尝试影响自己中心的操作人员来提供帮助。
