Department of Pathology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
Hum Pathol. 2012 May;43(5):702-7. doi: 10.1016/j.humpath.2011.06.017. Epub 2011 Sep 19.
During the last decade, whole slide images have been used in many areas of pathology such as teaching, research, digital archiving, teleconsultation, and quality assurance testing. However, whole slide images have as yet not much been used for up-front diagnostics because of the lack of validation studies. The aim of this study was, therefore, to test the feasibility of whole slide images for diagnosis of gastrointestinal tract specimens, one of the largest areas of diagnostic pathology. One hundred gastrointestinal tract biopsies and resections that had been diagnosed using light microscopy 1 year before were rediagnosed on whole slide images scanned at ×20 magnification by 5 pathologists (all reassessing their own cases), having the original clinical information available but blinded to their original light microscopy diagnoses. The original light microscopy and whole slide image-based diagnoses were compared and classified as concordant, slightly discordant (without clinical consequences), and discordant. The diagnoses based on light microscopy and the whole slide image-based rediagnoses were concordant in 95% of the cases. Light microscopy and whole slide image diagnosis in the remaining 5% of cases were slightly discordant, none of these were with clinical or prognostic implications. Up-front histopathologic diagnosis of gastrointestinal biopsies and resections can be done on whole slide images.
在过去的十年中，全切片图像已在病理学的许多领域得到应用，如教学、研究、数字存档、远程咨询和质量保证测试。然而，由于缺乏验证研究，全切片图像在前端诊断中尚未得到广泛应用。因此，本研究旨在测试全切片图像在诊断胃肠道标本中的可行性，胃肠道标本是诊断病理学中最大的领域之一。100 例胃肠道活检和切除标本在 1 年前通过光学显微镜诊断，由 5 名病理学家（均重新评估自己的病例）对扫描的全切片图像（放大倍数为×20）进行重新诊断，这些病理学家可获得原始的临床信息，但对其原始的光学显微镜诊断结果不知情。将原始的光学显微镜诊断和全切片图像诊断进行比较，并分类为一致、略有不一致（无临床后果）和不一致。95%的病例中，基于光学显微镜和全切片图像的重新诊断是一致的。在其余 5%的病例中，光学显微镜和全切片图像的诊断略有不一致，但均无临床或预后意义。胃肠道活检和切除的初步组织病理学诊断可以通过全切片图像来完成。
