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在资源有限的国家中,细胞病理学诊断对早期癌症诊断的重要性。

Importance of Cytopathologic Diagnosis in Early Cancer Diagnosis in Resource-Constrained Countries.

机构信息

Centre of Social Medicine & Community Health, JNU, New Delhi, India.

WHO Classification of Tumours, International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France.

出版信息

JCO Glob Oncol. 2022 Feb;8:e2100337. doi: 10.1200/GO.21.00337.

Abstract

PURPOSE

The rising cancer burden in low- and middle-income countries (LMICs) stresses already weak health care systems and poses unique challenges. In resource-constrained LMICs and in circumstances where most patients must pay out of pocket for diagnostic tests, these may not be available or affordable for many. Cytopathology provides a simple, inexpensive, standardized, and low-technology diagnostic procedure that is increasingly used as an effective tool to address the hurdles faced in cancer control programs in LMICs. This review explores the potential role of cytopathology in LMICs in reducing the cancer burden.

METHODS

This review studied the existing literature across the globe regarding the utilization of cytopathology as a diagnostic or screening tool for various types of malignancies as well as its advantages and disadvantages, depending on the local situation.

RESULTS

Apart from the usefulness of cytopathology, this review also sheds light on the barriers to using cytopathology in LMICs. Most recently, SARS-CoV-2 has produced several unique challenges for cytopathology. These are being met with innovative measures to combat the effects of the pandemic and ensure the safe delivery of essential cytopathology services.

CONCLUSION

The usefulness of cytopathologic techniques has been demonstrated via various studies, even during the recent pandemic. If cytology is to be used appropriately, the focus needs to be on integrating it into the national cancer screening and diagnostic programs as well as providing well-trained human resources.

摘要

目的

中低收入国家(LMICs)癌症负担不断增加,这给本已薄弱的医疗保健系统带来了压力,同时也带来了独特的挑战。在资源有限的 LMICs 中,以及在大多数患者必须自费进行诊断测试的情况下,对于许多人来说,这些测试可能无法获得或负担得起。细胞病理学提供了一种简单、廉价、标准化和低技术的诊断程序,它越来越被用作解决 LMICs 癌症控制计划中面临的障碍的有效工具。本综述探讨了细胞病理学在降低癌症负担方面在 LMICs 中的潜在作用。

方法

本综述研究了全球范围内关于细胞病理学作为诊断或筛查工具用于各种类型恶性肿瘤的现有文献,以及根据当地情况,其优缺点。

结果

除了细胞病理学的有用性外,本综述还揭示了在 LMICs 中使用细胞病理学的障碍。最近,SARS-CoV-2 给细胞病理学带来了一些独特的挑战。正在采取创新措施来应对大流行的影响,确保提供基本的细胞病理学服务的安全性。

结论

通过各种研究表明了细胞病理学技术的有用性,即使在最近的大流行期间也是如此。如果要适当地使用细胞学,重点需要放在将其纳入国家癌症筛查和诊断计划以及提供经过良好培训的人力资源上。

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