Karim R Z, van den Berg K S, Colman M H, McCarthy S W, Thompson J F, Scolyer R A
Department of Anatomical Pathology; Sydney Melanoma Unit, Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia.
Histopathology. 2008 Jan;52(2):130-8. doi: 10.1111/j.1365-2559.2007.02921.x.
Although the synoptic format is being increasingly used for primary cutaneous melanoma pathology reporting, no study assessing its value has yet been reported in the literature. The aim was to determine whether the use of synoptic reports increases the frequency with which pathological features that may influence prognosis and guide management are documented.
Melanoma pathology reports (n = 1692) were evaluated; 904 were in a synoptic format [671 Sydney Melanoma Unit (SMU) reports and 233 non-SMU reports] and 788 were non-synoptic (184 SMU reports and 604 non-SMU reports). Reports (n = 1354) from 677 patients who had both a SMU report and a non-SMU report were compared. Almost all features were reported more frequently in synoptic than in non-synoptic reports (P < 0.001). No significant differences were found in the frequency of reporting the main pathological features between SMU and non-SMU synoptic reports. Synoptic reports were more frequently used by SMU (78%) than by non-SMU pathologists (28%).
This is the first study to provide objective evidence that synoptic pathology reports for melanoma are more complete than non-synoptic reports (regardless of whether the reports are generated within or outside a specialist melanoma centre). All synoptic reports should include the facility for free text, be tailored to individual institutional requirements and be updated regularly to be of maximal value.
尽管概要格式越来越多地用于原发性皮肤黑色素瘤的病理报告,但文献中尚未有评估其价值的研究报告。本研究旨在确定使用概要报告是否会增加记录可能影响预后和指导治疗的病理特征的频率。
对黑色素瘤病理报告(n = 1692份)进行评估;其中904份采用概要格式[671份悉尼黑色素瘤中心(SMU)报告和233份非SMU报告],788份为非概要格式(184份SMU报告和604份非SMU报告)。对677例患者的SMU报告和非SMU报告(共1354份)进行比较。几乎所有特征在概要报告中的记录频率均高于非概要报告(P < 0.001)。SMU和非SMU概要报告在主要病理特征的记录频率上未发现显著差异。SMU(78%)比非SMU病理学家(28%)更频繁地使用概要报告。
本研究首次提供了客观证据,表明黑色素瘤的概要病理报告比非概要报告更完整(无论报告是在专业黑色素瘤中心内还是外生成)。所有概要报告都应具备自由文本功能,根据各机构的具体要求进行定制,并定期更新以发挥最大价值。