Williams J O, Goddard M J, Gresham G A, Wyatt B A
East Anglia Regional Clinical Audit Team, Clinical School, Addenbrooke's Hospital, Cambridge, UK.
J Clin Pathol. 1997 Aug;50(8):695-8. doi: 10.1136/jcp.50.8.695.
To examine current practice and to establish criteria for the use of histopathology in necropsy practice.
During an audit of necropsy reporting, consensus could not be reached about the use of routine histopathology. Therefore local guidelines were formulated and current practice was compared with these guidelines. Fifteen consecutive necropsies undertaken by each consultant were reviewed and the use of histopathology noted.
In general, the standard of necropsy reporting was reasonably high. Tissue was retained for histopathology in 25% of necropsies and 72% of these necropsy reports included a histopathology report. Using the guidelines, the assessors judged that histopathology might have been valuable in a further 19%. It was felt that routine histopathology would not have been helpful in determining the cause of death in the remaining 56%. The importance of the pathologist's clinical judgement in individual cases was stressed. At reaudit, nearly two years later, there was no significant change in practice, reflecting the lack of consensus.
Even when histopathology might contribute to finding the cause of death, it was not always done. However, the assumption that histology is invariably helpful in determining the cause of death is challenged.
审视当前的做法，并确立尸检实践中组织病理学应用的标准。
在一次尸检报告审核期间，对于常规组织病理学的应用无法达成共识。因此制定了当地指南，并将当前做法与这些指南进行比较。对每位会诊医生连续进行的15例尸检进行了回顾，并记录了组织病理学的应用情况。
总体而言，尸检报告的标准相当高。25%的尸检保留了组织用于组织病理学检查，其中72%的尸检报告包含组织病理学报告。根据指南，评估人员判断在另外19%的尸检中组织病理学可能会有价值。认为在其余56%的尸检中常规组织病理学对确定死因没有帮助。强调了病理学家在个别病例中的临床判断的重要性。在将近两年后的重新审核中，实践没有显著变化，这反映了缺乏共识。
即使组织病理学可能有助于找出死因，但并不总是进行。然而，组织学在确定死因方面总是有帮助的这一假设受到了挑战。
