全切片图像扫描技术在临床病理诊断工作中的应用

The application of whole slide images in clinicopathologic diagnosis

目的探讨全切片图像扫描技术(whole slide images,WSI)在日常病理诊断工作中的应用价值与效果。方法选取300例连续的组织学病例作为研究对象,将所有样本的病理切片运用WSI技术进行数字化扫描,在电脑屏幕上阅读数字化切片后作出病理诊断。再将在显微镜下常规病理切片的病理诊断与在电脑屏幕上数字化切片的病理诊断进行对比,分析WSI技术在日常病理诊断工作中的应用效果。结果 300例HE染色的常规病理切片与数字化病理切片诊断病变性质的总体符合率为98.67%(296/300)。300例HE染色的常规病理切片与数字化病理切片诊断病变种类完全符合272例(90.67%),部分符合9例(3.00%),不符合19例(6.33%)。与经验丰富的上级医师制定的标准答案比较,常规病理切片与数字化病理切片诊断HE染色、亚甲基蓝染色、免疫组织化学染色的符合率差异均无统计学意义(P>0.05)。结论在日常病理诊断工作中,同一医师在显微镜下常规病理切片的病理诊断与在电脑屏幕上数字化病理切片的病理诊断有较高的符合率。随着医学信息数字化的不断发展,数字病理在教学、诊断、科学研究和数据保存上的优势会越来越明显,数字病理在将来的病理日常工作中也会变得越来越重要。

Objective To explore the practical value and effect of whole slide images（WSI）in daily clinicopathological diagnosis.Methods The 300 consecutive cases were chosen as the research object and applied digital scanning to all the histological slices by using WSI.Then,we reviewed digital slices on the computer screen and made pathological diagnosis.Finally,we compared the pathological diagnosis between traditional hematoxylin-eosin（HE）slices under the microscope and digital slices on the computer screen,analyzed the practical value and effect of WSI in daily clinicopathological diagnosis.Results In terms of the nature of disease in 300 cases of HE staining slices,the overall coincidence rate between microscope diagnosis and computer screen diagnosis was 98.67%（296/300）.In terms of the specific disease types in 300 cases of HE staining slices,the respective rate of complete coincidence,partial coincidence and inconformity between microscope diagnosis and computer screen diagnosis was 90.67%（272/300）,3.00%（9/300）and 6.33%（19/300）.When compared with the standard answers made by the senior pathologist,there was no significantly statistical difference in the coincidence rate between microscope diagnosis and computer screen diagnosis in HE staining,methylene blue staining and immunohistochemistry（P〈0.05）.Conclusion In daily work,the coincidence rate between microscope diagnosis and computer screen diagnosis made by the same pathologist is high.With the development of medical information digitization,the advantages of digital pathology in teaching,diagnosis,scientific research and data storage will be more and more obvious.Moreover,the role of digital pathology in daily clinicopathological diagnosis will become more and more important in the future.