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胆囊切除术标本中追加采样的作用:一项多中心前瞻性研究。

The Contribution of Additional Sampling in Cholecystectomy Materials: A Multicenter Prospective Study.

机构信息

Department of Pathology, İzmir Tepecik Education and Research Hospital, İZMİR, TURKEY.

出版信息

Turk Patoloji Derg. 2020;36(3):188-194. doi: 10.5146/tjpath.2020.01483.

Abstract

OBJECTIVE

Cholecystectomy materials are frequently encountered in routine practice. The aim of this study was to determine the true frequency of gallbladder lesions, the diagnostic consistency, and standardization of reports after macroscopic sampling and microscopic evaluation based on previously defined criteria.

MATERIAL AND METHOD

14 institutions participated in the study within the Hepato-Pancreato-Biliary Pathology Study Group. Routinely examined cholecystectomies within the last year were included in the study in these institutions. Additional sampling was performed according to the indications and criteria. The number of blocks and samples taken in the first macroscopic examination and the number of blocks and samples taken in the additional sampling were determined and the rate of diagnostic contribution of the additional examination was determined.

RESULTS

A total of 5,244 cholecystectomy materials from 14 institutions were included in the study. Additional sampling was found to be necessary in 576 cases (10.98%) from all institutions. In the first macroscopic sampling, the mean of the numbers of samples was approximately 4 and the number of blocks was 2. The mean of the numbers of additional samples and blocks was approximately 8 and 4, respectively. The diagnosis was changed in 144 of the 576 new sampled cases while the remaining 432 stayed unaltered.

CONCLUSION

In this study, it was observed that new sampling after the first microscopic examination of cholecystectomy materials contributed to the diagnosis. It was also shown that the necessity of having standard criteria for macroscopic and microscopic examination plays an important role in making the correct diagnosis.

摘要

目的

胆囊切除术标本在日常实践中经常遇到。本研究旨在确定胆囊病变的真实频率、基于先前定义的标准进行宏观采样和微观评估后的诊断一致性和报告标准化。

材料和方法

14 家机构在肝胰胆病理研究组内参与了这项研究。这些机构在过去一年中常规检查的胆囊切除术标本被纳入了这项研究。根据适应证和标准进行了额外的采样。确定了首次宏观检查中采集的块数和样本数,以及额外采样中采集的块数和样本数,并确定了额外检查的诊断贡献率。

结果

来自 14 家机构的总共 5244 份胆囊切除术标本被纳入了这项研究。所有机构的 576 例(10.98%)需要进行额外采样。在首次宏观采样中,样本数的平均值约为 4,块数为 2。额外采样的样本数和块数的平均值分别约为 8 和 4。在 576 例新采样病例中,有 144 例诊断发生了变化,而其余 432 例则保持不变。

结论

在这项研究中,观察到在首次对胆囊切除术标本进行微观检查后进行新的采样有助于诊断。还表明,对宏观和微观检查有标准标准的必要性对于做出正确诊断起着重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08d5/10510599/65e1a6d00362/TurkPatolojiDerg-36-8817-g001.jpg

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