Leong F J, Graham A K, Schwarzmann P, McGee J O
Nuffield Department of Pathology & Bacteriology, University of Oxford, John Radcliffe Hospital, Headington, UK.
Telemed J E Health. 2000 Winter;6(4):373-7. doi: 10.1089/15305620050503834.
Telepathology is a potential alternative to conventional histopathology. A clinical trial using a robotic telepathology system was conducted to assess the clinical and technical utility and effectiveness of telepathology in the U.K. breast screening pathology quality assurance program. Eighty-seven cases of breast disease were chosen at random from a series of 192 cases from the U.K. Breast Screening Pathology National Quality Assurance Scheme (NEQAS) collection. There were 20 benign, 23 carcinoma in situ (CIS), and 44 invasive malignant cases. The diagnostic accuracy of telepathology (TP) compared with conventional light microscopic (LM) diagnosis was 98.8%; this included a single case deferred for LM examination. The figure was similar when compared with expert consensus diagnosis (CD). In invasive tumor typing, TP accuracy was 95.4% (42/44 cases), the difference being attributable to slide color fading and would have had no impact on patient management. The accuracy of TP versus LM and expert consensus in tumor grading was 91.3% for carcinoma in situ (21/23 cases), a discordance with no relevance to patient management. TP grading of invasive tumor compared with LM diagnosis, had an accuracy of 86.4% (38/44) with a clinically significant accuracy of 97.7% (43/44). The time taken for TP diagnosis averaged 3.9 minutes per case by the end of the study. This data demonstrates that telepathology diagnostic accuracy is comparable to conventional microscopy and may therefore be envisaged as an alternative to conventional light microscopy for more rapid proficiency testing in breast screening (and perhaps other) quality assurance schemes.
远程病理学是传统组织病理学的一种潜在替代方法。在英国乳腺癌筛查病理质量保证项目中，开展了一项使用机器人远程病理学系统的临床试验，以评估远程病理学的临床和技术实用性及有效性。从英国乳腺癌筛查病理国家质量保证计划（NEQAS）收集的192例病例中随机选取了87例乳腺疾病病例。其中有20例良性病例、23例原位癌（CIS）和44例浸润性恶性病例。与传统光学显微镜（LM）诊断相比，远程病理学（TP）的诊断准确率为98.8%；这其中包括1例因需进行光学显微镜检查而延迟诊断的病例。与专家共识诊断（CD）相比，该数字相似。在浸润性肿瘤分型方面，TP的准确率为95.4%（44例中的42例），差异归因于玻片颜色褪色，且这对患者管理没有影响。在肿瘤分级方面，TP与LM及专家共识相比，原位癌的准确率为91.3%（23例中的21例），这种不一致与患者管理无关。浸润性肿瘤的TP分级与LM诊断相比，准确率为86.4%（44例中的38例），临床显著准确率为97.7%（44例中的43例）。到研究结束时，TP诊断每个病例平均耗时3.9分钟。这些数据表明，远程病理学诊断准确率与传统显微镜相当，因此在乳腺癌筛查（或许还有其他方面）质量保证计划中，可设想将其作为传统光学显微镜的替代方法，用于更快速的能力验证测试。
