Sunnybrook Research Institute, Toronto, Ontario, Canada.
J Surg Oncol. 2011 Mar 1;103(3):248-56. doi: 10.1002/jso.21827.
Adherence to guidelines for adequate gastric cancer specimen assessment is poor in North America. Inadequate staging and poor prognosis were noted in some series when these guidelines are not met. Recent advances have been made in standardizing cancer pathology reports in Canada; however, the uptake of these reporting systems is unknown for gastric cancer. A survey of pathologists in Ontario was performed to outline the processing techniques and practices for assessing gastric cancer specimens.
A survey was designed through a collaboration of surgical oncologists, general surgeons, pathologists, and research staff. Pathologists were identified using the College of Physicians and Surgeons of Ontario and MD Select databases. Participants were surveyed online or by mail-out.
The response rate was 40.2% (147/366). Vascular invasion, perineural invasion, and signet ring cells were all reported as being examined for by the majority of pathologists. Fat clearing solution and keratin immunohistochemical techniques were not reported as being consistently utilized. Less than 70% of pathologists indicated using a form of synoptic report.
Variations in practice and technique were observed. This may or may not reflect differences in quality of care or simply preferences for achieving equivalent results in the absence of standardized procedures. Education, evidence-based procedural guidelines and further research are required to provide infrastructure and support for pathologists and surgeons involved in the care of gastric cancer patients.
在北美，胃癌标本评估指南的遵循情况不佳。在某些系列中，如果不遵守这些指南，就会出现分期不足和预后不良的情况。加拿大在癌症病理报告标准化方面取得了一些进展；然而，这些报告系统在胃癌中的采用情况尚不清楚。对安大略省的病理学家进行了一项调查，以概述评估胃癌标本的处理技术和实践。
通过外科肿瘤学家、普通外科医生、病理学家和研究人员的合作设计了一项调查。使用安大略省医师和外科医生学院和 MD Select 数据库来确定参与者。参与者通过在线或邮寄方式进行调查。
回复率为 40.2%（147/366）。大多数病理学家都报告检查了血管侵犯、神经周围侵犯和印戒细胞。脂肪清除溶液和角蛋白免疫组织化学技术并未被报告为一致使用。不到 70%的病理学家表示使用了一种综合报告形式。
观察到实践和技术存在差异。这可能反映了护理质量的差异，也可能仅仅是在缺乏标准化程序的情况下对达到等效结果的偏好。需要教育、基于证据的程序指南和进一步的研究，为参与胃癌患者护理的病理学家和外科医生提供基础设施和支持。
