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胆囊切除术后偶然诊断出的胆囊癌的病理报告评估:法国多中心调查结果。

Pathology report assessment of incidental gallbladder carcinoma diagnosed from cholecystectomy specimens: results of a French multicentre survey.

机构信息

Department of Pathology, Amiens University Medical Center, Jules Verne University of Picardie, Amiens, France.

出版信息

Dig Liver Dis. 2013 Dec;45(12):1056-60. doi: 10.1016/j.dld.2013.07.004. Epub 2013 Aug 13.

Abstract

AIMS

To assess the accuracy of pathology reports on gallbladder specimens from patients operated on for incidental gallbladder carcinoma.

METHODS

Demographic data, details on pathological reports including gross and microscopic features section were recorded in 100 selected patients with incidental gallbladder carcinoma diagnosed from 2004 to 2007.

RESULTS

Pathology reports had a conventional format in 93% of cases, without any standardization. Turnaround time ranged from 1 to 35 days. Frozen sections were performed in 20% of cases. The reports failed to give information on prognostic histological factors: exact tumour site (missing in 55% of cases), depth of tumour infiltration within the gallbladder wall (missing in 10%), surgical margins (missing in 40% for the cystic duct margin), tumour differentiation (missing in 28%), vascular invasion (missing in 52%) and perineural invasion (missing in 51%). Lymph node status could be assessed in 44% of cases. Distances between the tumour and the cystic duct and circumferential margins were not specified in 68% and 84% of cases. Only 29% of the reports clearly stated the pTNM stage in the conclusion section. The pT stage with margin status and tumour site was only mentioned in 30% of the reports.

CONCLUSION

Pathology reports on gallbladder carcinoma from participating centres frequently lacked important information on key prognostic histological factors.

摘要

目的

评估对因偶然胆囊癌而接受手术的患者的胆囊标本的病理报告的准确性。

方法

记录了 2004 年至 2007 年间确诊为偶然胆囊癌的 100 例患者的人口统计学数据、病理报告中的详细信息,包括大体和显微镜特征部分。

结果

93%的病例病理报告采用常规格式,没有任何标准化。周转时间从 1 天到 35 天不等。20%的病例进行了冰冻切片。报告未能提供有关预后组织学因素的信息:肿瘤的确切部位(55%的病例缺失)、肿瘤在胆囊壁内的浸润深度(10%缺失)、手术切缘(胆囊管切缘缺失 40%)、肿瘤分化(缺失 28%)、血管侵犯(缺失 52%)和神经周围侵犯(缺失 51%)。仅 44%的病例可以评估淋巴结状态。肿瘤与胆囊管之间的距离和环形切缘在 68%和 84%的病例中未明确说明。仅有 29%的报告在结论部分清楚地说明了 pTNM 分期。报告中仅提及 30%的病例的 pT 分期、切缘状态和肿瘤部位。

结论

来自参与中心的胆囊癌病理报告经常缺乏关键预后组织学因素的重要信息。

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