Sturm-O'Brien Angela K, Hicks John M, Giannoni Carla M, Sulek Marcelle, Friedman Ellen M
Bobby R Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
Int J Pediatr Otorhinolaryngol. 2010 Feb;74(2):161-3. doi: 10.1016/j.ijporl.2009.10.028. Epub 2009 Nov 26.
To evaluate the optimal utilization of histopathologic analysis of tonsil and adenoid specimens in the pediatric population.
A retrospective review was performed on 7837 tonsil and adenoid specimens submitted from January 2004 to April 2008. The records were reviewed for the patients' age, sex, and pathologic analysis. The time and cost per analysis of each specimen were determined.
Histopathology was performed on 347 specimens based on clinical suspicion by the surgeon, a difference of 0.5 cm or more among tonsils, gross abnormalities, and history of malignancy, transplant, or immunocompromise. Malignancy was diagnosed in 0.026% of patients. Post-transplant lymphoproliferative disease was diagnosed in 6 of 24 immunocompromised patients. The use of these criteria resulted in a savings of $518,088.47 and 461 h of dedicated technician time per year.
Histologic examinations in selected specimens should be based on specific criteria that should be determined by each hospital based on hospital size, finances and input from their pathologists and otolaryngogists. Storage of a representative specimen for possible retrospective review may be useful.
评估小儿扁桃体和腺样体标本组织病理学分析的最佳利用情况。
对2004年1月至2008年4月提交的7837份扁桃体和腺样体标本进行回顾性研究。查阅患者的年龄、性别及病理分析记录。确定每份标本每次分析的时间和成本。
基于外科医生的临床怀疑，对347份标本进行了组织病理学检查，这些标本的扁桃体之间差异达0.5厘米或更大、存在肉眼可见异常以及有恶性肿瘤、移植或免疫功能低下病史。0.026%的患者被诊断为恶性肿瘤。24名免疫功能低下患者中有6人被诊断为移植后淋巴细胞增生性疾病。采用这些标准每年节省了518,088.47美元以及461小时的专门技术人员时间。
选定标本的组织学检查应基于特定标准，各医院应根据医院规模、财务状况以及病理学家和耳鼻喉科医生的意见来确定这些标准。保存一份代表性标本以供可能的回顾性研究或许有用。
