基层医院基于远程数字病理的术中冰冻诊断应用实践
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摘要
目的:探讨远程数字病理应用于基层医院术中冰冻诊断的意义、可行性以及存在的问题。方法:回顾分析416例冰冻诊断病例的病变部位分布、数字切片数量及质量、报告用时、准确率。结果:病例以卵巢、乳腺、甲状腺和子宫标本为主,共占85.58%(356/416),平均每例切片数为1.62张,报告平均用时为41.33 min,91.59%(381/416)在45 min内能得到诊断结果,诊断准确率为97.60%(406/416)。结论:远程数字病理可以有效帮助基层医院解决术中冰冻诊断中的困难;但实现此技术在基层医院广泛和长期应用,需要探索一个更优化的操作流程以及更完善的质控体系。
Objective: To investigate the significance, feasibility and existing problems of the remote digital pathology consultation platform in the intraoperative frozen section diagnosis in primary hospital. Methods: The distribution of the lesions, the quantity and quality of the digital sections, the time and accuracy of the reports were analyzed retrospectively in 416 cases. Results: The specimens of ovary, breast, thyroid and uterus accounted for 85.58%(356/416). The average number of slices was 1.62. The average time of intraoperative frozen report was 41.33 minutes. 91.59%( 381/416) cases were diagnosed within 45 minutes. The accuracy of intraoperative frozen diagnosis was 97.60%( 406/416). Conclusion: The remote digital pathology can solve the difficulties in intraoperative frozen diagnosis for primary hospital. However, it is necessary to explore a more optimized operation flow and a more perfect quality control system to realize the wide and long term application of this technology in primary hospital.
Objective: To investigate the significance, feasibility and existing problems of the remote digital pathology consultation platform in the intraoperative frozen section diagnosis in primary hospital. Methods: The distribution of the lesions, the quantity and quality of the digital sections, the time and accuracy of the reports were analyzed retrospectively in 416 cases. Results: The specimens of ovary, breast, thyroid and uterus accounted for 85.58%(356/416). The average number of slices was 1.62. The average time of intraoperative frozen report was 41.33 minutes. 91.59%( 381/416) cases were diagnosed within 45 minutes. The accuracy of intraoperative frozen diagnosis was 97.60%( 406/416). Conclusion: The remote digital pathology can solve the difficulties in intraoperative frozen diagnosis for primary hospital. However, it is necessary to explore a more optimized operation flow and a more perfect quality control system to realize the wide and long term application of this technology in primary hospital.
引文
[1]谢蕴,韩晓洁,李慧楚,等.探索远程病理诊断在医疗援疆中的应用[J].中国卫生资源,2016,19(3):213-220.
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[6]Pantanowitz L,Sinard JH,Henricks WH,et al.Validating whole slide imaging for diagnostic purposes in pathology:guideline from the College of American Pathologists Pathology and Laboratory Quality Center[J].Arch Pathol Lab Med,2013,137(12):1710-1722.
[2]张雨涛,周洪园,唐云、等.地市级医院292例远程病理会诊病例分析[J].临床与实验病理学杂志,2016,32(1):64-67.
[3]袁静,张华,刘长兴.数字病理信息系统的设计与实现[J].中国医疗设备,2013,28(9):36-38.
[4]Evans AJ,Chetty R,Clarke B,et al.Primary frozen section diagnosis by robotic microscopy and virtual slide telepathology:the UniversityHealth Network experience[J].Seminars in Diagnostic Pathology,2009,26(4):165-176.
[5]方建晨,金惠铭,叶扶桑,等.实时术中远程数字病理会诊系统探索性应用[J].中国数字医学,2014,9(10):65-67.
[6]Pantanowitz L,Sinard JH,Henricks WH,et al.Validating whole slide imaging for diagnostic purposes in pathology:guideline from the College of American Pathologists Pathology and Laboratory Quality Center[J].Arch Pathol Lab Med,2013,137(12):1710-1722.