Wei Jeffrey T, Miller Eric A, Woosley John T, Martin Christopher F, Sandler Robert S
Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina 27599-7080, USA.
Cancer. 2004 Mar 15;100(6):1262-7. doi: 10.1002/cncr.20090.
In 1996, the Association of Directors of Anatomic and Surgical Pathology (ADASP) published recommendations for colon carcinoma reporting. Since this publication, no study has evaluated physician practice in relation to these recommendations. The objectives of the current study were to describe pathology reporting for colon carcinoma, evaluate potential variations in reporting, and identify areas for improvement.
Data were obtained from a population-based study of incident colon carcinoma in 33 counties in North Carolina between 1997 and 2000. All subjects with surgically resected colon carcinoma of tumor stage T2-T4 with available surgical pathology reports were eligible for inclusion in the current analysis. The authors reviewed pathology reports for adherence to recommendations of the ADASP.
Four hundred thirty-eight pathology reports were included for analysis. Adherence to ADASP recommendations was < 90% for descriptions of how specimen was received (68%), how specimen was identified (71%), macroscopic depth of penetration (82%), appearance of serosa adjacent to tumor (50%), and status of residual bowel (73%). All other criteria were reported in > 90% of patients. Teaching hospital and contract pathology laboratories had greater adherence to recommendations, compared with community hospital laboratories. Hospitals with the highest colon carcinoma case volume demonstrated greater adherence to recommendations, compared with low-volume hospitals.
Pathology reports were effective in communicating most pertinent findings from surgically resected colon carcinoma specimens. Omissions of some critical characteristics did occur, however, and significant variability in reporting existed based on laboratory affiliation and hospital case volume.
1996年，解剖与外科病理学主任协会（ADASP）发布了结肠癌报告的建议。自该出版物发表以来，尚无研究评估医生在这些建议方面的实践情况。本研究的目的是描述结肠癌的病理报告，评估报告中的潜在差异，并确定改进的领域。
数据来自1997年至2000年在北卡罗来纳州33个县进行的一项基于人群的结肠癌发病研究。所有接受手术切除且肿瘤分期为T2 - T4且有可用手术病理报告的结肠癌患者均符合纳入本分析的条件。作者审查病理报告以确定是否符合ADASP的建议。
共纳入438份病理报告进行分析。对于标本接收方式（68%）、标本识别方式（71%）、宏观浸润深度（82%）、肿瘤邻近浆膜的外观（50%）和残留肠段状态（73%）的描述，符合ADASP建议的比例<90%。所有其他标准在>90%的患者中报告。与社区医院实验室相比，教学医院和合同制病理实验室对建议的遵守程度更高。与低病例量医院相比，结肠癌病例量最高的医院对建议的遵守程度更高。
病理报告有效地传达了手术切除结肠癌标本的大多数相关发现。然而，确实存在一些关键特征的遗漏，并且基于实验室附属关系和医院病例量，报告存在显著差异。
