Yoshizawa Akihiko, Tanaka Mitsuru
Rinsho Byori. 2017 Jan;65(1):26-31.
Whole-slide imaging (WSI) technology enables the primary diagnosis of histopathological slides. This study aimed to determine the diagnostic concordance between pathological interpretations made using WSI and those made using light microscopy (LM). For this study, 5,704 consecutive surgical pathological cases from a community hospital were included. The specimens were digitized at x40 magnification for biopsy and endoscopic resection specimens or at x20 magnification for other specimens and evaluated by 11 pathologists for diagnosis using WSI. Subsequently, the specimens were signed out using LM by 3 pathologists after 2 weeks. Diagnoses using WSI were then compared with the diagnoses made by using LM. Most (96.8%) of the 5,704 specimens were obtained from the gastrointestinal tract (2,441 biopsy specimens from the esophagogastroduodenum [42.7%], 1,678 endoscopic resection specimens from the colorectum [29.4%], 1,349 biopsy specimens from the colorectum [23.6%], 133 resected specimens from the gallbladder [2.3%], 56 endoscopic resection specimens from the stomach [0.9%], 30 resected specimens from the ap- pendix [0.5%], 14 skin biopsy specimens [0.2%], and 3 other specimens [0.1%]). The overall concordance between the diagnoses made using WSI and those made using LM was 95.1%. The major and minor dis- crepancy rates for WSI were 0.1% and 4.8%, respectively. None of the discordant cases had any clinical or prognostic implications. In conclusion, this study revealed that WSI can be used for primary diagnosis of gastrointestinal biopsy and endoscopic resection specimens. To the best of our knowledge, this is one of the studies that clearly proved that diagnosis using WSI is equivalent to diagnosis using LM. [Original].
全切片成像(WSI)技术可实现组织病理学切片的初步诊断。本研究旨在确定使用WSI做出的病理学解释与使用光学显微镜(LM)做出的病理学解释之间的诊断一致性。在本研究中,纳入了一家社区医院连续的5704例手术病理病例。活检和内镜切除标本在40倍放大率下进行数字化处理,其他标本在20倍放大率下进行数字化处理,并由11名病理学家使用WSI进行诊断评估。随后,3名病理学家在2周后使用LM对标本进行签发诊断。然后将使用WSI做出的诊断与使用LM做出的诊断进行比较。5704例标本中的大多数(96.8%)来自胃肠道(2441例食管胃十二指肠活检标本[42.7%],1678例结肠直肠内镜切除标本[29.4%],1349例结肠直肠活检标本[23.6%],133例胆囊切除标本[2.3%],56例胃内镜切除标本[0.9%],30例阑尾切除标本[0.5%],14例皮肤活检标本[0.2%],以及3例其他标本[0.1%])。使用WSI做出的诊断与使用LM做出的诊断之间的总体一致性为95.1%。WSI的主要和次要差异率分别为0.1%和4.8%。所有不一致的病例均无任何临床或预后意义。总之,本研究表明WSI可用于胃肠道活检和内镜切除标本的初步诊断。据我们所知,这是明确证明使用WSI进行诊断等同于使用LM进行诊断的研究之一。[原文]