大型学术机构中普通病理学家和乳腺亚专科病理学家在免疫组织化学应用方面的差异。
Differences in immunohistochemistry utilization by general and breast subspecialty pathologists at a large academic institution.
机构信息
Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, 1161 21st Avenue South, MCN CC3322, Nashville, TN 37232-2561, United States of America.
Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, United States of America.
出版信息
Ann Diagn Pathol. 2019 Oct;42:92-95. doi: 10.1016/j.anndiagpath.2019.08.004. Epub 2019 Aug 17.
OBJECTIVES
Immunohistochemistry (IHC) can be a useful adjunct in diagnostic breast pathology, but best practices have not been clearly established. We sought to compare the patterns of p63 utilization between general pathologists (GP) and subspecialized breast pathologists (BP), analyze diagnostic discrepancy rates, and identify types of lesions requiring immunohistochemistry.
METHODS
The pathology database was searched over 6-year period to identify breast needle core biopsy cases utilizing p63 and subsequent excision results.
RESULTS
P63 was ordered more frequently by BP (2.3% of cores) compared to GP (1.1% of cores, p = 0.0005). The most frequent utilization of p63 by GP for benign lesions (44.0%) followed by invasive carcinomas (36.0%) while BP most frequently ordered p63 on invasive carcinomas (49.5%) and DCIS (26.6%).
CONCLUSIONS
While IHC use may be thought to be most helpful to those with less experience or knowledge in breast pathology, these results suggest that utilization is increased with subspecialty training.
目的
免疫组织化学（IHC）在诊断乳腺病理学中是一种有用的辅助手段，但尚未明确确立最佳实践。我们试图比较普通病理学家（GP）和乳腺病理专科医生（BP）之间使用 p63 的模式，分析诊断差异率，并确定需要免疫组织化学的病变类型。
方法
在 6 年的时间内，对利用 p63 进行乳腺针芯活检的病例进行了病理数据库检索，并对后续的切除结果进行了分析。
结果
BP 比 GP 更频繁地订购 p63（BP 为 2.3%的核心，GP 为 1.1%的核心，p=0.0005）。GP 最常将 p63 用于良性病变（44.0%），其次是浸润性癌（36.0%），而 BP 最常订购 p63 用于浸润性癌（49.5%）和 DCIS（26.6%）。
结论
尽管认为免疫组化的使用对那些在乳腺病理学方面经验或知识较少的人最有帮助，但这些结果表明，随着专业培训的增加，其利用率也在增加。
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