数字病理近程会诊相干文献

  • 1、细胞DNA倍体剖析取通例细胞学诊断对宫颈上皮内瘤变诊断评价的对照(中华临床医师杂志(电子版) 2008年11月)

    作者:童华, 李凤山

    关键字:液基细胞学,宫颈上皮内瘤变

    择要:

    目标评价接纳DNA定量分析要领停止宫颈癌普查的工作效率和准确性。要领对到场宫颈癌普查的3070名妇女用宫颈刷取材,停止液基薄层制片,离别停止巴氏染色和Feulgen染色,由细胞学医师对巴氏染色片做通例细胞学诊断,运用全自动DNA倍体剖析对Feulgen染色片停止主动扫描诊断。效果对通例细胞搜检效果正在不明意义的非典型鳞状上皮(ASCUS)及以上病例和全自动DNA倍体剖析体系搜检可见同倍体细胞或同倍体细胞峰的病例,发起进一步做阴道镜搜检和宫颈活检。146名妇女做了病理活检。以病理诊断效果为尺度,盘算通例细胞学诊断和细胞DNA定量分析要领正在筛查CINⅡ及以上宫颈病变的敏感性、特异性、阳性展望值、阴性展望值。以3个DNA异倍体作为评价CINⅡ及以上病理改动,其敏感性、特异性、阳性展望值、阴性展望值分别是80.95%、57.60%、24.29%、57.60%,除阴性展望值外均比通例细胞搜检为初级别鳞状上皮内病变及以上级别评价CINⅡ及以上病理改动尺度(分别是76.19%、40.00%、17.58%、90.90%)要下,其他级别中3个DNA异倍体取AS-CUS、≥10个DNA异倍体取初级别鳞状上皮内病变响应目标对照均下。同时,细胞DNA定量分析图客观正确,不只能辨认宫颈细胞涂片中的大量DNA异倍体,借能辨认少许DNA同倍体细胞,对临床事情的指点有较主要的意义。结论细胞DNA定量分析要领能较好天进步宫颈癌普查的阳性检出率。

  • 2、Assessment of diagnostic accuracy and feasibility of dynamic telepathology in China(Human Pathology, 2008,39, 236–242)

    作者:Xinxia Li, Encong Gong, Jiang Gu

    关键字:运用研讨, 地区观察

    择要:

    To assess the feasibility, including diagnostic accuracy and time cost, of a real-time telepathology system with pathologic slides, 600 cases covering a wide spectrum of lesions from 16 organ systems were tested. The "correct" diagnosis (gold standard) was established as a consensus by 2 experienced pathologists. The cases were first examined by 4 pathologists at different levels of experience with dynamic telepathology. Cases were then reviewed by the same pathologists using light microscopy in a blinded fashion 3 weeks to 2 months later. A diagnosis, together with reading times for telepathology and light microscopy, was recorded for each case. Diagnostic accuracy by telepathology was 94.8% (569/600), 93.3% (560/600), 91.6% (550/600), and 97% (388/400) for pathologists A, B, C, and D, respectively. Telepathologic diagnosis was concordant with the gold standard and with direct microscopy, with a mean of 94.2% and 99.26%, respectively. Most cases (510 or 85%) were diagnosed in 15 to 40 minutes by telepathology, with a mean of 17.0 minutes. The time needed to review a slide by telepathology was 3 to 4 times longer than that of standard light microscopy. All 4 pathologists were able to render a diagnosis in all cases. Our results showed that robotic telepathology is sufficiently accurate for primary diagnosis in surgical pathology, but modifications in laboratory protocols, telepathology hardware, and internet speed are needed to reduce the time necessary for diagnosis by telepathology before this method may be deemed suitable for use in a busy practice.