Takahashi M, Shimada O, Shirasawa K, Kimura M
SRL Cytopath Science, Hachioji.
Rinsho Byori. 1993 May;41(5):596-9.
A quality assurance (QA) program for histopathology and cytology has not yet been completed although an inhouse quality control for technical standardization is being tested. The fact that a strict Performance Improvement Program of CAP (College of American Pathologists) for cytology is required separately from other laboratory tests emphasizes the importance of cytology, since erroneous cytology reports would directly cause incorrect clinical diagnosis. The results of questionnaires gathered by the QA Committee of the Japan Association of Registered Clinical Laboratories on preparation techniques, workload limits of pathologists and technologists, double diagnostic systems, error detection programs, and specialization of personnel are presented. In addition to pathology and cytology proficiency testing provided by CAP survey, a model of blind QC (quality control) in our laboratory is discussed; for diagnostic standardization of histopathology, reexamination of randomly selected cases by another pathologist and reexamination of previously diagnosed cases by the same doctor are periodically performed. For error detection of cytoscreening, cytologists are obligated to reexamine random samples of 1 to 10% of negative gynecological slides. Evaluation of sufficiency of slides as required by the Bethesda System is referred to diagnostic interpretation.
尽管正在测试技术标准化的内部质量控制，但组织病理学和细胞学的质量保证（QA）计划尚未完成。美国病理学家学会（CAP）针对细胞学的严格性能改进计划需要与其他实验室检测分开进行，这一事实凸显了细胞学的重要性，因为错误的细胞学报告将直接导致临床诊断错误。本文介绍了日本注册临床实验室协会QA委员会收集的有关制片技术、病理学家和技术人员工作量限制、双重诊断系统、错误检测程序以及人员专业化的问卷调查结果。除了CAP调查提供的病理学和细胞学能力验证外，还讨论了我们实验室的盲法质量控制（QC）模型；为实现组织病理学诊断标准化，定期由另一位病理学家对随机选择的病例进行复查，并由同一位医生对先前诊断的病例进行复查。为了检测细胞筛查中的错误，细胞学家有义务对1%至10%的阴性妇科玻片随机样本进行复查。按照贝塞斯达系统要求评估玻片的充足性，参考诊断解释。
