Haack Lori A, Shalkham John
Department of Clinical Laboratories, Cytopathology D4/259, University of Wisconsin Hospital and Clinics, Madison, Wisconsin 53792-2472, USA.
Diagn Cytopathol. 2007 Aug;35(8):529-34. doi: 10.1002/dc.20683.
The cytology laboratory has traditionally performed a relatively small variety of tests. The testing processes employed were generally manually performed and included preparation of glass slide materials, staining of these slides, coverslipping, and microscopic evaluation of the cellular material. Instrumentation in the cytology laboratory was very limited and included a centrifuge, membrane filtration system, and possibly an automated staining machine. If instruments were added, for example, a liquid based preparation device or an automated coverslipping device; the instruments were rarely checked to assure they were operating properly before implementation into clinical practice. In addition, little documentation was maintained with regards to the instrument performance evaluation process. Increasing automation and expansion of testing options have changed how cytopathology is practiced. There are many new devices employed for the preparation of specimens, staining and coverslipping of slides, and evaluation of cellular material. The increasing use of molecular testing methods in cytopathology further adds to the changing landscape of cytopathology. New instrumentation and testing methods are routinely being introduced and the cytopathology laboratory must assure that the testing performed is accurate and consistent. Cytopathology laboratory professionals need to appreciate the value of validation of the tests we perform and the instruments we use in order to best serve the patient. Our clinical laboratory colleagues have traditionally performed validation on both instruments and test methods before using them for clinical testing. If cytopathology wants to perform the complex testing being introduced and effectively utilize new instrumentation, we need to understand the value of validation and how we apply validation to our laboratory practice.
传统上,细胞学实验室开展的检测种类相对较少。所采用的检测流程一般都是手工操作,包括玻片材料的制备、玻片染色、加盖盖玻片以及对细胞材料进行显微镜评估。细胞学实验室的仪器设备非常有限,包括一台离心机、一个膜过滤系统,可能还有一台自动染色机。如果增添仪器,例如液体标本制备装置或自动加盖盖玻片装置,在将这些仪器投入临床实践之前,很少会对其进行检查以确保其正常运行。此外,关于仪器性能评估过程的记录也很少。检测自动化程度的提高以及检测选项的扩展改变了细胞病理学的实践方式。现在有许多新设备用于标本制备、玻片染色和加盖盖玻片以及细胞材料评估。细胞病理学中分子检测方法的使用日益增多,这进一步改变了细胞病理学的格局。新的仪器设备和检测方法不断被引入,细胞病理学实验室必须确保所进行的检测准确且一致。细胞病理学实验室专业人员需要认识到我们所进行的检测以及所使用的仪器设备进行验证的价值,以便更好地为患者服务。我们临床实验室的同事传统上在将仪器和检测方法用于临床检测之前都会对其进行验证。如果细胞病理学想要开展新引入的复杂检测并有效利用新的仪器设备,我们需要理解验证的价值以及如何将验证应用于我们的实验室实践。