Wang Liping, Leng Bing, Rampisela Debby
Department of Pathology, Baylor Scott and White Medical Center - Temple, Temple, Texas.
Proc (Bayl Univ Med Cent). 2021 Jul 9;34(6):649-653. doi: 10.1080/08998280.2021.1941700. eCollection 2021.
Intraoperative pathology consultation plays an important role in the management of surgical patients and is also a measure for quality control in surgical pathology. A retrospective study was conducted to review intraoperative consultation during a 5-year period at a single institution. There were 19,145 intraoperative pathology consultation cases, including 19,026 concordant cases, 71 (<1%) frozen discordant cases, 11 (<1%) gross discordant cases, and 37 (<1%) deferred cases. Among frozen discordant cases, the most common cause for discordance was histologic sampling error (52.1%), followed by misinterpretation (42.3%). The most common major (clinically significant) frozen discordance was histologic sampling error for skin margins (32.4%), followed by histologic sampling error for lymph node metastasis (13.5%). Although our discordant rate (0.43%) was lower than that in previously reported studies (2%-8%), our major discordant rate was relatively high (50%). This review suggests that deeper sectioning of the blocks could improve the quality of our intraoperative consultations.
术中病理会诊在外科患者的管理中起着重要作用，也是外科病理学质量控制的一项措施。进行了一项回顾性研究，以回顾某单一机构5年期间的术中会诊情况。共有19145例术中病理会诊病例，包括19026例一致病例、71例（<1%）冰冻切片不一致病例、11例（<1%）大体标本不一致病例和37例（<1%）延迟病例。在冰冻切片不一致病例中，最常见的不一致原因是组织学取材错误（52.1%），其次是误判（42.3%）。最常见的主要（具有临床意义）冰冻切片不一致情况是皮肤切缘的组织学取材错误（32.4%），其次是淋巴结转移的组织学取材错误（13.5%）。虽然我们的不一致率（0.43%）低于先前报道的研究（2%-8%），但我们的主要不一致率相对较高（50%）。本综述表明，对组织块进行更深层次的切片可以提高我们术中会诊的质量。
