Nourbakshs Mahra, Du Liping, Acosta Andres M, Alaghehbandan Reza, Amin Ali, Amin Mahul B, Aron Manju, Berney Daniel, Brimo Fadi, Chan Emily, Cheng Liang, Colecchia Maurizio, Dhillon Jasreman, Downes Michelle R, Evans Andrew J, Harik Lara R, Hassan Oudai, Haider Aiman, Humphrey Peter A, Jha Shilpy, Kandukuri Shivani, Kao Chia-Sui Sunny, Kaushal Seema, Khani Francesca, Kryvenko Oleksandr N, Kweldam Charlotte, Lal Priti, Lobo Anandi, Maclean Fiona, Magi-Galluzzi Cristina, Mehra Rohit, Miyamoto Hiroshi, Mohanty Sambit K, Montironi Rodolfo, Nesi Gabriella, Netto George Jabboure, Nguyen Jane K, Nourieh Maya, Osunkoya Adeboye O, Paner Gladell P, Sangoi Ankur R, Shah Rajal B, Srigley John R, Tretiakova Maria, Troncoso Patricia, Trpkov Kiril, Van Der Kwast Theodorus H, Zhang Miao, Zynger Debra L, Williamson Sean R, Giannico Giovanna A
NeoGenomics Laboratories, Aliso Viejo, CA, USA.
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
Histopathology. 2025 Aug;87(2):206-222. doi: 10.1111/his.15469. Epub 2025 May 13.
Standardizing pathology reporting protocols through peer consensus review is critical for the best quality of care metrics. Reporting heterogeneity due to discrepancies among professional societies and practice patterns may lead to heterogeneous management and treatment approaches. This issue prompted a multi-institutional survey of pathologists to address potential similarities or differences in trends and practice patterns in prostate pathology reporting worldwide.
A REDCap survey was distributed among 175 pathologists worldwide, recruited through invitations and social media. The response rate among invited pathologists was 83%. The practice locations were as follows: North America (USA, Canada, and Mexico, 62%), Europe (17%), Australia/New Zealand (3%), Central/South America (2%), Asia (13%), and Africa (2%). Most pathologists practiced for <5 years (28%). A genitourinary (GU) pathology fellowship was completed by 37%, 58% practiced in a subspecialized setting, and 43% in academia. Reporting includes (63%) or subtracts (37%) intervening benign tissue. Both Gleason score and Grade Groups (GG)s were reported by 96% of responders, whereas 94% report percent pattern 4 (%4). Aggregate grading and volume estimation in undesignated cores with different grades in the same jar are reported by 73% and 54% for systematic biopsies, and 83% and 62% for targeted biopsies, respectively. Cribriform morphology was reported by 81%. For presumed intraductal carcinoma (IDC), 89% use basal cell markers when isolated (iIDC), 82% with GG1 cancer, and 37% with ≥GG2. iIDC or IDC associated with GG1 or with ≥GG2 was not graded by 90%, 78%, and 70%, respectively. In radical prostatectomies, 90% report %4, but only 53% report it if the overall grade is ≥7. A tumour with Gleason 3 + 3 = 6 and <5% pattern 4 was graded as GG2 by 64%. A <5% cutoff for defining tertiary pattern was used by 74%, and 80% report >5% pattern 4 or 5 as a secondary pattern. Grading was assigned based on the dominant nodule by 59%. Finally, reporting practices were significantly associated with demographic characteristics.
Although most issues are agreed upon, significant discordance is identified among societies and pathologists in different practice settings. We hope this survey will serve as the basis for future studies and new collaborative approaches to more standardized reporting practices.
通过同行共识评审来规范病理报告方案对于实现最佳医疗质量指标至关重要。由于专业学会之间的差异和实践模式导致的报告异质性可能会导致管理和治疗方法的不一致。这一问题促使开展了一项针对病理学家的多机构调查，以探讨全球前列腺病理报告趋势和实践模式中的潜在异同。
通过邀请和社交媒体在全球范围内招募了175名病理学家参与一项REDCap调查。受邀病理学家的回复率为83%。实践地点分布如下：北美（美国、加拿大和墨西哥，62%）、欧洲（17%）、澳大利亚/新西兰（3%）、中/南美洲（2%）、亚洲（13%）和非洲（2%）。大多数病理学家的从业时间不足5年（28%）。37%的病理学家完成了泌尿生殖系统（GU）病理 fellowship，58%在亚专业环境中工作，43%在学术机构工作。报告中包括（63%）或减去（37%）中间的良性组织。96%的受访者同时报告了Gleason评分和分级组（GG），而94%的受访者报告了4级模式百分比（%4）。对于系统性活检，73%和54%的受访者分别报告了同一标本瓶中不同分级的未指定核心的综合分级和体积估计，对于靶向活检，这一比例分别为83%和62%。81%的受访者报告了筛状形态。对于疑似导管内癌（IDC），89%在孤立性导管内癌（iIDC）时使用基底细胞标志物，82%在GG1癌时使用，37%在≥GG2癌时使用。iIDC或与GG1或≥GG2相关的IDC分别有90%、78%和70%未进行分级。在根治性前列腺切除术中，90%的受访者报告了%4，但如果总体分级≥7，只有53%的受访者报告了%4。Gleason 3+3=6且4级模式<5%的肿瘤被64%的受访者分级为GG2。74%的受访者使用<5%的阈值来定义三级模式，80%的受访者将>5%的4级或5级模式报告为二级模式。59%的受访者根据主要结节进行分级。最后，报告实践与人口统计学特征显著相关。
尽管大多数问题已达成共识，但在不同实践环境中的学会和病理学家之间仍发现了显著的不一致。我们希望这项调查将成为未来研究和新的合作方法的基础，以实现更标准化的报告实践。
