Xu Chun, Chen Ling, Feng An-Ning, Nie Ling, Fu Yao, Li Lin, Li Wei, Sun Qi
Department of Pathology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China.
World J Gastrointest Endosc. 2025 Mar 16;17(3):101525. doi: 10.4253/wjge.v17.i3.101525.
Endoscopic submucosal dissection (ESD) is a standardized therapeutic approach for early carcinoma of the digestive tracts. In this regard, the process of histopathological diagnosis requires standardization. However, the uneven development of healthcare in China, especially in eastern and western China, creates challenges for sharing a standardized diagnostic process.
To optimize the process of ESD specimen sampling, embedding and slide production, and to provide complete and accurate pathological reports.
We established a practical process of specimen sampling, created standardized reporting templates, and trained pathologists from neighboring hospitals and those in the western region. A training effectiveness survey was conducted, and the collected data were assessed by the corresponding percentages.
A total of 111 valid feedback forms have been received, among which 58% of the participants obtained photographs during specimen collection, whereas the percentage increased to 79% after training. Only 58% and 62% of the respondents ensured the mucosal tissue strips were flat and their order remained unchanged; after training, these two proportions increased to 95% and 92%, respectively. Approximately half the participants measured the depth of the submucosal infiltration, which significantly increased to 95% after training. The percentage of pathologists who did not evaluate lymphovascular invasion effectively reduced. Only 22% of the participants had fixed clinic-pathological meetings before training, which increased to 49% after training. The number of participants who had a thorough understanding of endoscopic diagnosis also significantly increased.
There have been significant improvements in the process of specimen collection, section quality, and pathology reporting in trained hospitals. Therefore, our study provides valuable insights for others facing similar challenges.
内镜黏膜下剥离术（ESD）是消化道早期癌的标准化治疗方法。在这方面，组织病理学诊断过程需要标准化。然而，中国医疗保健发展不均衡，尤其是东西部地区，这给共享标准化诊断过程带来了挑战。
优化ESD标本取样、包埋和玻片制作流程，并提供完整准确的病理报告。
我们建立了实用的标本取样流程，创建了标准化报告模板，并对周边医院及西部地区的病理学家进行培训。开展了培训效果调查，并通过相应百分比对收集的数据进行评估。
共收到111份有效反馈表，其中58%的参与者在标本采集时获取了照片，培训后这一比例增至79%。只有58%和62%的受访者确保黏膜组织条平整且顺序不变；培训后，这两个比例分别增至95%和92%。约一半参与者测量了黏膜下浸润深度，培训后这一比例显著增至95%。未有效评估脉管侵犯的病理学家比例降低。培训前只有22%的参与者定期召开临床病理会议，培训后增至49%。对内镜诊断有深入了解的参与者数量也显著增加。
接受培训医院的标本采集、切片质量和病理报告流程有了显著改善。因此，我们的研究为面临类似挑战的其他人提供了有价值的见解。
