Jhun Iny, Levy David, Lim Harumi, Herrera Quintina, Dobo Erika, Burns Dominique, Hetherington William, Macasaet Ronald, Young April J, Kong Christina S, Folkins Ann K, Yang Eric Joon
Department of Pathology, School of Medicine, Stanford University, Stanford, CA, USA.
J Pathol Inform. 2021 Jan 8;12:2. doi: 10.4103/jpi.jpi_82_20. eCollection 2021.
Digital pathology has been increasingly implemented for primary surgical pathology diagnosis. In our institution, digital pathology was recently deployed in the gynecologic (GYN) pathology practice. A notable challenge encountered in the digital evaluation of GYN specimens was high rates of scanning failure of specimens with fragmented as well as scant tissue. To improve tissue detection failure rates, we implemented a novel use of the collodion bag cell block preparation method.
In this study, we reviewed 108 endocervical curettage (ECC) specimens, representing specimens processed with and without the collodion bag cell block method ( = 56 without collodion bag, = 52 with collodion bag).
Tissue detection failure rates were reduced from 77% (43/56) in noncollodion bag cases to 23/52 (44%) of collodion bag cases, representing a 42% reduction. The median total area of tissue detection failure per level was 0.35 mm (interquartile range [IQR]: 0.14, 0.70 mm) for noncollodion bag cases and 0.08 mm (IQR: 0.03, 0.20 mm) for collodion bag cases. This represents a greater than fourfold reduction in the total area of tissue detection failure per level ( < 0.001). In addition, there were no out-of-focus levels among collodion bag cases, compared to 6/56 (11%) of noncollodion bag cases (median total area = 4.9 mm).
The collodion bag method significantly improved the digital image quality of fragmented/scant GYN curettage specimens, increased efficiency and accuracy of diagnostic evaluation, and enhanced identification of tissue contamination during processing. The logistical challenges and labor cost of deploying the collodion bag protocol are important considerations for feasibility assessment at an institutional level.
数字病理学已越来越多地应用于原发性外科病理学诊断。在我们机构，数字病理学最近已部署到妇科（GYN）病理学实践中。在对妇科标本进行数字评估时遇到的一个显著挑战是，组织碎片多以及组织稀少的标本扫描失败率很高。为了提高组织检测失败率，我们采用了火棉胶袋细胞块制备方法的新用途。
在本研究中，我们回顾了108例宫颈管刮术（ECC）标本，分别代表采用和未采用火棉胶袋细胞块方法处理的标本（未采用火棉胶袋的标本n = 56，采用火棉胶袋的标本n = 52）。
组织检测失败率从未采用火棉胶袋的病例中的77%（43/56）降至采用火棉胶袋病例中的23/52（44%），降低了42%。未采用火棉胶袋病例每级组织检测失败的总面积中位数为0.35平方毫米（四分位间距[IQR]：0.14，0.70平方毫米），采用火棉胶袋病例为0.08平方毫米（IQR：0.03，0.20平方毫米）。这表明每级组织检测失败的总面积减少了四倍多（P < 0.001）。此外，采用火棉胶袋的病例中没有失焦层面，而未采用火棉胶袋的病例中有6/56（11%）存在失焦层面（总面积中位数 = 4.9平方毫米）。
火棉胶袋方法显著提高了组织碎片多/稀少的妇科刮除术标本的数字图像质量，提高了诊断评估的效率和准确性，并增强了处理过程中组织污染的识别。采用火棉胶袋方案的后勤挑战和劳动力成本是机构层面可行性评估的重要考虑因素。
