Salmon H A, Smith J H F, Balsitis M
Department of Histopathology, Northern General Hospital NHS Trust, Sheffield S5 7AU, UK.
J Clin Pathol. 2002 Jan;55(1):67-8. doi: 10.1136/jcp.55.1.67.
To determine whether microscopic examination of macroscopically normal hysterectomy specimens yields findings that could alter subsequent clinical management.
All pathology reports on hysterectomy specimens submitted to the department of histopathology at the Northern General Hospital from January 1997 to December 1998 were reviewed. Cases were included for further assessment if the hysterectomy specimen was regarded as macroscopically normal by a consultant pathologist and if the patient had no history of, or suspicion of, neoplastic disease. The subsequent microscopic findings from these cases were assessed to determine whether any lesions of clinical importance were identified.
Eight hundred and fifty four specimens were reviewed, of which 139 were suitable for inclusion. Only one of the 139 cases harboured a microscopic abnormality that necessitated specific clinical follow up; this was a focus of cervical intraepithelial neoplasia 2 (CIN 2). On follow up of that patient, no further neoplastic disease was identified.
Microscopic assessment of macroscopically normal hysterectomy specimens does not contribute to patient management and is unnecessary in an era of manpower shortage and cost containment.
确定对宏观上正常的子宫切除标本进行显微镜检查是否能得出可改变后续临床管理的结果。
回顾了1997年1月至1998年12月提交至北方总医院组织病理学部门的所有子宫切除标本的病理报告。如果子宫切除标本被病理科顾问认为宏观上正常，且患者无肿瘤疾病史或疑似肿瘤疾病史，则将这些病例纳入进一步评估。对这些病例随后的显微镜检查结果进行评估，以确定是否发现任何具有临床重要性的病变。
共审查了854份标本，其中139份适合纳入研究。139例病例中只有1例存在需要特定临床随访的显微镜下异常；这是一例宫颈上皮内瘤变2级（CIN 2）。对该患者进行随访时，未发现进一步的肿瘤疾病。
对宏观上正常的子宫切除标本进行显微镜评估无助于患者管理，在人力短缺和成本控制的时代是不必要的。
