Department of Diagnostic Pathology, Kobe University Hospital, Kobe, Japan.
Pathol Int. 2019 Jun;69(6):341-349. doi: 10.1111/pin.12808. Epub 2019 Jul 11.
Whole slide imaging (WSI) is being increasingly used worldwide. Although previous studies have asserted the validity of WSI diagnosis, they have primarily targeted only small specimens and excluded cases requiring immunohistochemistry or special staining, such as lymphoma. The purpose of this study was to evaluate the accuracy of WSI diagnosis of lymphoma, for which 240 biopsies and resections of lymphoma cases were selected from the study set of lymphomas. All slides including H&E, immunohistochemical and special staining were digitized using a WSI image scanner. An experienced pathologist performed the WSI diagnoses, which were compared with original diagnoses based on light microscopic examinations. Discrepancy between the two interpretations were classified into three categories: concordance, minor discrepancy (no clinical significance), and major discrepancy (with clinical significance). Overall concordance between the light microscopic and WSI diagnosis was found in 223 cases (92.92%; 95%CI = 88.90-95.82), minor discrepancy in fifteen (6.25%; 95%CI = 3.54-10.10), and major discrepancy in two (0.83%; 95%CI = 0.10-2.98). Diagnosis of lymphoma using WSI appeared to be mostly accurate, suggesting that WSI may be a reliable technology for the diagnosis of lymphoma.
全切片成像(WSI)在全球范围内的应用日益广泛。尽管之前的研究已经证实了 WSI 诊断的有效性,但它们主要针对的是小标本,并且排除了需要免疫组织化学或特殊染色的病例,如淋巴瘤。本研究旨在评估 WSI 诊断淋巴瘤的准确性,为此从淋巴瘤研究组中选择了 240 例淋巴瘤活检和切除标本。使用 WSI 图像扫描仪对包括 H&E、免疫组织化学和特殊染色的所有切片进行数字化。一位经验丰富的病理学家进行了 WSI 诊断,并将其与基于光镜检查的原始诊断进行比较。两种解释之间的差异分为三类:一致、轻微差异(无临床意义)和重大差异(有临床意义)。在 223 例(92.92%;95%CI=88.90-95.82)中,光镜和 WSI 诊断结果完全一致,15 例(6.25%;95%CI=3.54-10.10)存在轻微差异,2 例(0.83%;95%CI=0.10-2.98)存在重大差异。使用 WSI 诊断淋巴瘤的结果大多是准确的,这表明 WSI 可能是一种可靠的淋巴瘤诊断技术。