Epstein Jonathan I, Srigley John, Grignon David, Humphrey Peter
Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD 21231, USA.
Hum Pathol. 2007 Sep;38(9):1305-9. doi: 10.1016/j.humpath.2007.05.015.
It has been evident for decades that pathology reports are very variable even within a single institution. Standardization of reporting is the optimal way to insure that information necessary for patient management, prognostic and predictive factor assessment, grading, staging, analysis of outcomes, and tumor registries are included in pathology reports. The ADASP has chosen a pathologist expert in each field to assemble a group from within the pathology community (with clinician input if desired) to write specific cancer protocols. These were then approved by the ADASP council and subsequently by the membership. The American College of Surgery Commission on Cancer (COC) accredits cancer centers in the United States. Recently, the COC decided to require elements, deemed as essential by the CAP, to be described in all pathology reports in their accredited cancer centers as of January 2004. Importantly, they do not require that the specific College of Pathologists (CAP) protocols or synoptic reports be used. ADASP has updated all of its protocols to comply with the COC requirements in the form of uniform checklists. The checklists use the staging criteria cited in the American Joint Committee on Cancer 2002 staging manual (sixth edition) but include a variety of other references listed in each of the checklists. Moreover, the checklists are formatted for ease of use. They may be used as templates for uniform reporting and are designed to be compatible with voice-activated transcription. The different elements in these revised ADASP diagnostic checklists have been divided into Required and Optional. The term Required in this context only signifies compliance with the COC guidelines. ADASP realizes that specimens and practices vary, and it will not be possible to report these elements in every case. However, ADASP hopes that pathologists will find these checklists useful in daily clinical practice while facilitating compliance with the new COC requirements.
几十年来一直很明显的是,即使在同一机构内,病理报告也存在很大差异。报告的标准化是确保病理报告中包含患者管理、预后和预测因素评估、分级、分期、结果分析以及肿瘤登记所需信息的最佳方法。ADASP已在每个领域挑选了一位病理专家,从病理学界组建了一个小组(如有需要,可听取临床医生的意见)来编写特定的癌症诊疗规范。这些规范随后得到了ADASP委员会的批准,随后又得到了会员的认可。美国外科医师学会癌症委员会(COC)对美国的癌症中心进行认证。最近,COC决定自2004年1月起,要求其认可的癌症中心的所有病理报告中都要描述被CAP视为必不可少的要素。重要的是,他们并不要求使用特定的病理学家学会(CAP)诊疗规范或概要报告。ADASP已更新了其所有诊疗规范,以统一检查表的形式符合COC的要求。这些检查表使用了美国癌症联合委员会2002年分期手册(第六版)中引用的分期标准,但每个检查表中还包括各种其他参考文献。此外,检查表的格式便于使用。它们可作为统一报告的模板,并设计为与语音激活转录兼容。这些修订后的ADASP诊断检查表中的不同要素分为必填项和选填项。这里的“必填项”仅表示符合COC指南。ADASP意识到标本和操作各不相同,不可能在每种情况下都报告这些要素。然而,ADASP希望病理学家会发现这些检查表在日常临床实践中有用,同时便于符合新的COC要求。