Benton Leah G, Kallen Michael Edward, Jacobs Jonathan L, McCool Isaac E, Ning Yi, Duong Vu H, Koka Rima, Singh Zeba N
Department of Pathology, University of Maryland Medical Center, Baltimore, Maryland, USA.
Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
J Clin Pathol. 2023 Dec 14;77(1):68-72. doi: 10.1136/jcp-2023-209009.
The classification of haematological neoplasms recently underwent revision, generating two separate schemes-the International Consensus Classification and the fifth edition of the WHO classification. The new division into separate classification systems presents challenges for haematopathologists, haematologists/oncologists and patients. While it is too early to assess the full clinical impact, we sought to identify diagnostic discordance which may arise from applying separate classification schemes in myeloid neoplasia, and particularly in the challenging category of myelodysplastic syndrome/myeloproliferative neoplasms. A review of 64 such cases found 1 case with a significant discrepancy between the WHO and International Consensus Classification systems, and 9 cases with nominal discrepancies. Confusion from the use of conflicting diagnostic terms represents a potential source of patient harm, increased pathologist workload and burnout and erosion of clinician and patient trust.
血液肿瘤的分类最近进行了修订，产生了两个独立的方案——国际共识分类和世界卫生组织第五版分类。新的分类系统划分给血液病理学家、血液学家/肿瘤学家和患者带来了挑战。虽然现在评估其全面的临床影响还为时过早，但我们试图确定在髓系肿瘤中应用不同分类方案可能产生的诊断不一致情况，尤其是在具有挑战性的骨髓增生异常综合征/骨髓增殖性肿瘤类别中。对64例此类病例的回顾发现，有1例病例在世界卫生组织分类系统和国际共识分类系统之间存在显著差异，9例存在名义上的差异。使用相互冲突的诊断术语造成的混淆是对患者造成伤害的潜在来源，会增加病理学家的工作量和职业倦怠，并削弱临床医生和患者之间的信任。
