Chen Je, Jiao Yahui, Lu Chaohui, Zhou Jun, Zhang Zongjiu, Zhou Chen
Diagn Pathol. 2014;9 Suppl 1(Suppl 1):S2. doi: 10.1186/1746-1596-9-S1-S2. Epub 2014 Dec 19.
Telepathology may play an important role in pathology consultation and quality control for cancer diagnosis in China, as the country has the largest population of cancer patients worldwide. In 2011, the Pathology Quality Control Center of China and Ministry of Health developed and implemented a nationwide telepathology consultation and quality control program for cancer diagnosis in China. We here report the results of the two-year implementation and experiences.
the program built an Internet based telepathology platform to connect participating hospitals and expert consultants. The hardware and software used for the platform were validated in previous validation studies in China. The program had three regional centers consisting of Peking Union Medical College, Huasi Medical College of Sichuan and 2nd affiliated hospital of Zhejiang University. It also had 20 provincial consultation centers based in the provincial referral hospitals. 80 provincial or national pathologists served as expert consultants for the program, providing telepathology consultation for cancer diagnosis for more than 60 participating hospitals.
from 2011 to July 2013, 16,247 pathology cases were submitted to the platform for consultation. Among them, 84% were due to diagnostic difficulty and 16% were due to request by patients. The preliminary diagnosis provided by submitting pathologists were in agreement with expert opinion in 59.8% of cases but was in disagreement with expert opinion in 24.2% of cases. 16.0% of cases were not provided with preliminary diagnosis. The distribution of pathology cases by system or organ were: digestive system, 17.3%; gynecologic system, 16.7%; head and neck, 15.7%; bone and soft tissue, 10.4%; lung and mediastinum, 8.6%; breast, 7.6%; urinary system, 7.5%; hematopathology, 6.4%; skin, 5.2%; neuropathology, 2.5% and cytopathology, 1.3%. Expert consultants also provided assessment of quality of slide preparation and staining, online lectures and guidance for pathology quality control.
our results of two years' implementation indicated that telepathology could solve the problem of uneven distribution of pathology resources and provide a solution for countrywide pathology quality control in China. Telepathology could play an important role in improving pathology diagnosis in China.
在中国，远程病理学可能在癌症诊断的病理会诊和质量控制中发挥重要作用，因为中国是全球癌症患者人数最多的国家。2011年，中国病理学质量控制中心和卫生部制定并实施了一项针对中国癌症诊断的全国性远程病理会诊和质量控制计划。我们在此报告该计划两年实施的结果及经验。
该计划建立了一个基于互联网的远程病理学平台，以连接参与的医院和专家顾问。该平台所使用的硬件和软件在中国此前的验证研究中已得到验证。该计划有三个区域中心，分别由北京协和医学院、四川华西医学院和浙江大学第二附属医院组成。它还有20个设在省级转诊医院的省级会诊中心。80名省级或国家级病理学家担任该计划的专家顾问，为60多家参与医院的癌症诊断提供远程病理会诊。
2011年至2013年7月，16247例病理病例被提交至该平台进行会诊。其中，84%是由于诊断困难，16%是应患者要求。提交病理学家提供的初步诊断与专家意见在59.8%的病例中一致，但在24.2%的病例中与专家意见不一致。16.0%的病例未提供初步诊断。按系统或器官划分的病理病例分布情况为：消化系统，17.3%；妇科系统，16.7%；头颈部，15.7%；骨与软组织，10.4%；肺与纵隔，8.6%；乳腺，7.6%；泌尿系统，7.5%；血液病理学，6.4%；皮肤，5.2%；神经病理学，2.5%；细胞病理学，1.3%。专家顾问还对玻片制备和染色的质量进行评估，提供在线讲座并指导病理质量控制。
我们两年实施的结果表明，远程病理学可以解决病理资源分布不均的问题，并为中国全国范围的病理质量控制提供一种解决方案。远程病理学在中国改善病理诊断方面可发挥重要作用。
