Department of Pathology, Leopoldina Krankenhaus Schweinfurt GmbH, Germany.
Abbey Muensterschwarzach, Germany.
J Telemed Telecare. 2021 Apr;27(3):183-190. doi: 10.1177/1357633X19866564. Epub 2019 Aug 1.
Since 2007, a hospital in Tanzania has been supported with histopathological reports via telepathology (TP) by German pathologists. For this, the Internet-based platform iPath is used. The aim of this study was to analyse the rate of discrepancies in defined diagnostic groups. After shipment of paraffin-embedded tissue to Germany, specimens were processed according to recent diagnostic standards. All diagnoses were grouped into eight benign and 11 malignant main categories. The comparison comprised the following categories: 1, identical diagnosis; 2, mild discordance; 3, correct distinction between benign and malignant process, 4, false malignant; 5, false benign; and 6, no primary diagnosis possible. The cohort comprised 396 benign and 336 malignant diseases. Of the benign diseases, 62% were category 1, 23% category 2, 2% category 3, 6% category 4 and 7% category 6. Of the malignant diseases, 42% were category 1, 16% category 2, 12% category 3, 14% category 5 and 15% category 6. Exclusive support with static TP cannot meet all requirements of modern medical diagnostics. However, the project shows a approach for how pathologists in industrial countries can help low-income countries. In difficult cases, the opportunity for a final work-up using additional methods must be given for useful diagnostic purposes.
自 2007 年以来，坦桑尼亚的一家医院一直通过德国病理学家的远程病理学 (TP) 获得组织病理学报告。为此，使用了基于互联网的 iPath 平台。本研究的目的是分析在定义明确的诊断组中差异率。在将石蜡包埋组织运送到德国后，根据最新的诊断标准对标本进行处理。所有诊断分为 8 个良性和 11 个恶性主要类别。比较包括以下类别：1、相同的诊断；2、轻度不一致；3、良性和恶性过程之间的正确区分；4、假恶性；5、假良性；6、无法进行初步诊断。该队列包括 396 例良性疾病和 336 例恶性疾病。在良性疾病中，62%为类别 1，23%为类别 2，2%为类别 3，6%为类别 4，7%为类别 6。在恶性疾病中，42%为类别 1，16%为类别 2，12%为类别 3，14%为类别 5，15%为类别 6。单纯的静态远程病理学支持无法满足现代医学诊断的所有要求。然而，该项目展示了工业化国家的病理学家如何帮助低收入国家的一种方法。在困难的情况下，必须为有用的诊断目的提供使用其他方法进行最终检查的机会。
