Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Surg Oncol. 2010 Apr 1;101(5):430-5. doi: 10.1002/jso.21494.
This report analyzed a research project supported nationwide expert consultation of anatomic pathology in Taiwan.
The data were collected from the requisitions and consultation reports of 2,686 cases in this project from 2003 to 2006. The number of cases, tissue origin, additional special stains, turnaround time (TAT), concordance, discordance, referring pathologists, and consultants were analyzed.
Skin, hematopoietic system, and bone and soft tissue were the most common (48.3%) specimens sent for consultation. The tentative diagnosis and consultation diagnosis were discordant in 1,074 (64.3%) cases. Major discrepancy was seen in 205 (12.3%) cases, of which 66.8% were changed from malignant to benign, 21.0% were changed from benign to malignant, whereas 12.2% were changed from one category of malignancy to another. Additional special stains were performed on 38.7% of cases and hematology specimen was the most frequent. The mean TAT was 3.4 days. Pathologists working in institutes having fewer pathologists sent more cases for consultation. The opinion of the estimated annual consultation rate from the pathologists in Taiwan was 0.7%.
This program was beneficial simply by helping the referring pathologists in the workup and diagnosis. This result made the entire program a reasonable quality improvement program.
本报告分析了一项在台湾进行的全国解剖病理学专家咨询研究项目。
本研究收集了 2003 年至 2006 年间该项目 2686 例的申请单和咨询报告中的数据。对病例数量、组织来源、额外特殊染色、周转时间（TAT）、一致性、不一致性、送检病理医师和咨询医师进行了分析。
皮肤、造血系统和骨与软组织是最常送检进行咨询的标本（48.3%）。1074 例（64.3%）的初步诊断和咨询诊断不一致。205 例（12.3%）存在重大差异，其中 66.8%的病例由恶性变为良性，21.0%的病例由良性变为恶性，12.2%的病例由一种恶性变为另一种恶性。38.7%的病例进行了额外特殊染色，其中以血液学标本最常见。平均 TAT 为 3.4 天。病理医师人数较少的机构送检的病例更多。台湾病理医师估计的年咨询率为 0.7%。
该项目通过帮助送检病理医师进行检查和诊断，对他们的工作很有帮助。该结果使整个项目成为一项合理的质量改进计划。
