Kocjan G, Ramsay A, Beale T, O'Flynn P
Department of Cellular Pathology, University College London Hospitals NHSFoundation Trust, London, UK.
Cytopathology. 2009 Apr;20(2):69-77. doi: 10.1111/j.1365-2303.2009.00647.x.
This review highlights the role of cytopathology in cancer management within UK Head and Neck Cancer Networks and informs on the issues raised by recent UK Department of Health documents and other UK professional guidance. UK guidance requires the formal involvement of cytopathologists within multidisciplinary cancer teams, with medical and non-medical cytopathology staff setting up and running rapid access lump clinics, and support for image-guided fine needle aspiration cytology (FNAC) services. UK guidance also makes recommendations for training, resources and quality control. This review also highlights the resource gap between best practice evidence-based guidance for head and neck (HN) cancer services and existing UK provision for cytopathology, as evidenced by lack of availability of experienced staff and adequacy of training and quality control (QC). Finally, it stresses the importance in the UK of the Royal College of Pathologists' guidance, which defines the need for training, the experience needed for new consultants, the requirements for audit and QC. The implications for the additional resources required for HN cancer cytopathology services are discussed. Recent professional guidance specifying the provision of HN cancer services in the UK includes a cytopathology service for cancer networks, such as rapid access FNAC clinics. Although these clinics already operate in some institutions, there are many institutions where they do not and where the provision of cytopathology services would have to be restructured. This would need the support of local cancer networks and their acceptance of the detailed requirements for cytopathology, including resources, training and QC. The standards are not defined locally, as Strategic Health Authorities and Primary Care Trusts have been instructed by the Department of Health to support, invest and implement them.
本综述强调了细胞病理学在英国头颈癌网络癌症管理中的作用，并阐述了英国卫生部近期文件及其他英国专业指南所提出的问题。英国指南要求细胞病理学家正式参与多学科癌症团队，医学和非医学细胞病理学工作人员设立并运营快速就诊肿块诊所，并支持影像引导下细针穿刺抽吸细胞学（FNAC）服务。英国指南还对培训、资源和质量控制提出了建议。本综述还突出了头颈（HN）癌服务的最佳实践循证指南与英国现有细胞病理学服务之间的资源差距，这体现在缺乏经验丰富的工作人员、培训不足和质量控制（QC）方面。最后，强调了英国皇家病理学家学院指南的重要性，该指南明确了培训需求、新顾问所需经验、审核和QC要求。讨论了HN癌细胞病理学服务所需额外资源的影响。英国近期关于提供HN癌服务的专业指南包括为癌症网络提供细胞病理学服务，如快速就诊FNAC诊所。尽管这些诊所在一些机构已经运营，但在许多机构中尚未运营，且在这些机构中细胞病理学服务的提供需要进行重组。这需要当地癌症网络的支持以及它们对细胞病理学详细要求的认可，包括资源、培训和QC。由于卫生部已指示战略健康管理局和初级保健信托基金支持、投资并实施这些标准，所以标准并非由当地定义。
