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《妊娠滋养细胞疾病的专家病理学:迈向国际化多学科团队会议》。

Expert Pathology for Gestational Trophoblastic Disease: Towards an International Multidisciplinary Team Meeting.

机构信息

Department of Pathology, North West London Pathology (NWLP), Imperial College NHS Trust, London, UK.

Department of Pathology, Clínic Barcelona, Department of Basic Clinical Practice, University of Barcelona, Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.

出版信息

Gynecol Obstet Invest. 2024;89(3):166-177. doi: 10.1159/000536028. Epub 2024 Jan 8.

Abstract

BACKGROUND

Gestational trophoblastic disease (GTD), comprising hydatidiform moles and gestational trophoblastic tumours, is extremely rare. Exact diagnosis is crucial to indicate the appropriate treatment and to prevent complications. The scarcity and variability in the number of cases available for reporting, lack of specialised training in GTD, and non-existence of refresher courses implies that the pathologist dealing with these rare and, at times, extremely challenging cases is not completely confident in their diagnosis.

OBJECTIVES

The objective of this study was to explore the benefits of implementation of an international multidisciplinary conference (virtual) to aid diagnosis of difficult cases and support clinical management of GTD.

METHODS

A short survey was circulated to all 46 members of the EOTTD pathology and genetics working party and further spread to other colleagues who practice GTD. This showed that the pathologists and geneticists working with GTD patients do not feel adequately supported and equipped with dealing with these rare diseases.

OUTCOME

Virtual cross-border multidisciplinary team meetings (MDTs) were initiated in April 2022, bringing together participants from 11 European countries on a bi-yearly basis. Mean numbers of 3 patients are discussed during the MDTs followed by 3-4 quality assessment cases. A participant survey was conducted at the end of virtual meeting with an average satisfaction rate of 9.5. The pathologists felt supported and benefited from networking and clinical collaboration.

CONCLUSIONS AND OUTLOOK

This international MDT continues to provide support in managing the uncertainty with difficult and rare cases and enhances the pathologists training and experience. The frequency of meetings and the number of cases discussed per meeting will be increased in 2023 given the positive response. This will empower individuals and organisations to work together and improve diagnosis and the prognosis for these young patients.

摘要

背景

妊娠滋养细胞疾病(GTD)包括葡萄胎和妊娠滋养细胞肿瘤,非常罕见。准确诊断对于确定适当的治疗方案和预防并发症至关重要。由于可供报告的病例数量稀少且变化多端,缺乏 GTD 方面的专业培训,以及没有复习课程,因此处理这些罕见且有时极具挑战性病例的病理学家在诊断方面并非完全有把握。

目的

本研究旨在探讨实施国际多学科会议(虚拟会议)以辅助诊断疑难病例和支持 GTD 临床管理的益处。

方法

向 EOTTD 病理学和遗传学工作组的 46 名成员以及其他从事 GTD 工作的同事分发了一份简短的调查问卷。结果表明,与 GTD 患者一起工作的病理学家和遗传学家感到自己没有得到充分的支持和装备来处理这些罕见疾病。

结果

2022 年 4 月启动了虚拟跨境多学科团队会议(MDT),每年有来自 11 个欧洲国家的参与者参加。MDT 期间讨论了 3 例平均数量的患者,随后讨论了 3-4 例质量评估病例。在虚拟会议结束时进行了参与者调查,平均满意度为 9.5。病理学家感到得到了支持,并从网络和临床合作中受益。

结论和展望

这个国际 MDT 将继续为处理困难和罕见病例的不确定性提供支持,并增强病理学家的培训和经验。鉴于积极的反馈,2023 年将增加会议的频率和每次会议讨论的病例数量。这将使个人和组织能够共同努力,改善这些年轻患者的诊断和预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e64/11151979/eba8ca43bdd1/goi-2024-0089-0003-536028_F01.jpg

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