数字病理远程会诊平台在组织病理疑难病例诊断中的应用OACSTPCD
Application of digital pathology remote consultation platform in the diagnosis of challenging histopathological cases
目的:远程病理诊断虽在病理领域的各方面逐渐彰显出积极作用,但在疑难组织病理诊断中的应用情况尚不清楚.本研究探索数字病理远程会诊平台在组织病理诊断疑难病例的上级专家会诊中的应用.方法:选择重庆医科大学病理诊断中心2013年4月至2023年6月采用"数字病理远程诊断与质控平台"中的407例信息完整的组织病理疑难会诊病例为研究对象.对会诊病例的各系统/器官/科室比例、专家意见进行总结归类,评价会诊结果、分析会诊及时率.同时通过问卷调查分析本诊断中心病理医生对远程病理会诊平台的看法.结果:会诊病例系统/器官分类最多的3个为骨组织、软组织、女性生殖系统.本科室诊断意见与专家诊断结果的符合率为84.28%,不符合率为15.72%.远程会诊专家诊断时间为1 d的占67.81%,>5 d的占6.88%.问卷调查结果显示:80.95%的医师赞同或非常赞同"遇到疑难病例会选择远程会诊";85.71%的医师赞同或非常赞同"觉得从远程会诊中可以学习收获";病理、临床信息提供不全面,数字化图片质量不佳在"影响远程会诊质量的因素"中占比较高.结论:组织病理的远程会诊可以及时、有效地解决疑难病例的诊断问题,在为患者提供便捷就诊途径的同时,对病理医师病理诊断水平的提高也有积极作用,可为智能化诊疗模式的发展提供有益的参考.
Objective:Although remote pathological diagnoses is increasingly demonstrating positive impacts in various aspects of the pathology field,its application in the diagnosis of challenging histopathological cases remains unclear.This study explores the application of a digital pathology remote consultation platform for expert consultation in challenging histopathological diagnoses. Method:A total of 407 complete records of challenging histopathological consultation cases from the"Digital Pathology Remote Diagnosis and Quality Control Platform"used by the Pathological Diagnosis Center of Chongqing Medical University from April 2013 to June 2023 were selected as the study subjects.The cases were categorized by system/organ/department proportion of consultation cases and expert opinions were summarized and classified.The consultation results were evaluated,and the timeliness of the consultations was analyzed.A questionnaire survey was also conducted to gauge the opinions of pathologists at the diagnosis center regarding the remote pathological consultation platform. Results:The three most common systems/organs in consultation cases were bone tissue,soft tissue,and the female reproductive system.The concordance rate between the in-house diagnosis and expert consultation diagnosis was 84.28%,with a discordance rate of 15.72%.The time taken for remote expert consultation diagnosis was 1 day for 67.81%of cases and more than 5 days for 6.88%of cases.The survey results indicated that 80.95%of pathologists agreed or strongly agreed that they would choose remote consultation for challenging cases,and 85.71%agreed or strongly agreed that they could learn from remote consultations Factors negatively impacting the quality of remote consultations included incomplete pathology and clinical information and poor quality of digital images. Conclusion:Remote consultation in histopathology can timely and effectively resolve diagnostic issues in challenging cases.It provides a convenient way for patients to receive consultations and positively impacts the diagnostic skills of pathologists.This approach offers valuable reference points for the development of intelligent diagnostic and treatment models.
王成龙;薛英;王婷婷;赵娜;曹友德;喻姗姗
重庆市中医院病理科,重庆 400021||重庆医科大学基础医学院病理学教研室,重庆 400016||重庆医科大学分子医学检测中心,重庆 400016重庆医科大学基础医学院病理学教研室,重庆 400016||重庆医科大学分子医学检测中心,重庆 400016||重庆医科大学附属第一医院病理科,重庆 400016
远程会诊平台病理会诊数字病理组织病理诊断疑难病例临床病理
remote consultation platformpathology consultationdigital pathologyhistopathological diagnosischallenging casesclinical pathology
《临床与病理杂志》 2024 (005)
666-673 / 8
重庆医科大学智慧医学项目(ZHYX202210);重庆市科卫联合医学科研项目(2023MSXM060).This work was supported by the Intelligent Medicine Research Project of Chongqing Medical University(ZHYX202210)and Chongqing Science and Health Joint Medical Research Project(2023MSXM060),China.
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