Ntiamoah Peter, Monu Ngozi R, Abdulkareem Fatimah B, Adeniji Kayode A, Obafunwa John O, Komolafe Akinwumi O, Yates Clayton, Kaninjing Ernest, Carpten John D, Salhia Bodour, Odedina Folake T, Edelweiss Marcia, Kingham T Peter, Alatise Olusegun I
Memorial Sloan Kettering Cancer Center, New York, NY.
Weill Cornell Medical College, New York, NY.
J Glob Oncol. 2019 Sep;5:1-9. doi: 10.1200/JGO.19.00138.
Cancer incidence is increasing in sub-Saharan Africa, yet there is little information on the capacity of pathology laboratories in this region. We aimed to assess the current state of pathology services in Nigeria to guide strategies to ensure best practices and improve the quality of surgical specimen handling.
We developed structured pathology survey to assess tissue handling, sample processing, and immunohistochemistry (IHC) capabilities. The survey was distributed electronically to 22 medical centers in Nigeria that are part of established cancer consortia. Data were collected between September and October 2017.
Sixteen of 22 centers completed the survey in full. All 16 institutions had at least one board-certified pathologist and at least one full-time laboratory scientist/technologist. The majority of responding institutions (75%) reported processing fewer than 3,000 samples per year. For sample processing, 38% of institutions reported manual tissue processing and 75% processed biopsies and surgical specimens together. The average tissue fixation time ranged from 5 to more than 72 hours before processing and paraffin embedding. Half of the institutions reported having no quality assurance processes to evaluate hematoxylin and eosin-stained slides, and 25% reported having no written operating procedures. Half of the participating institutions have a facility for routine IHC staining, and among these there was considerable variability in processes and validation procedures. External proficiency testing was not common among surveyed sites (38%).
Data from 16 Nigerian medical institutions indicate deficiencies in standardization, quality control, and IHC validation that could affect the reliability of pathology results. These findings highlight addressable gaps in pathology services that can ensure accurate diagnosis and follow-up for the growing number of patients with cancer in this region.
撒哈拉以南非洲地区的癌症发病率正在上升，但关于该地区病理实验室能力的信息却很少。我们旨在评估尼日利亚病理服务的现状，以指导制定确保最佳实践并提高手术标本处理质量的策略。
我们制定了结构化病理调查，以评估组织处理、样本处理和免疫组织化学（IHC）能力。该调查通过电子方式分发给尼日利亚22个医疗中心，这些中心是既定癌症联盟的一部分。数据收集于2017年9月至10月之间。
22个中心中有16个完全完成了调查。所有16家机构都至少有一名获得董事会认证的病理学家和至少一名全职实验室科学家/技术人员。大多数回应机构（75%）报告称每年处理的样本少于3000个。对于样本处理，38%的机构报告采用手动组织处理，75%的机构将活检和手术标本一起处理。在处理和石蜡包埋之前，平均组织固定时间为5至72小时以上。一半的机构报告没有评估苏木精和伊红染色切片的质量保证流程，25%的机构报告没有书面操作程序。一半的参与机构具备常规IHC染色设施，在这些机构中，流程和验证程序存在很大差异。外部能力验证在接受调查的机构中并不常见（38%）。
来自16家尼日利亚医疗机构的数据表明，在标准化、质量控制和IHC验证方面存在缺陷，这可能会影响病理结果的可靠性。这些发现凸显了病理服务中可解决的差距，这些差距能够确保对该地区日益增多的癌症患者进行准确诊断和后续跟踪。
