数字化阅片在病理诊断中的可重复性和正确率研究

Study on repeatability and correctness of digital reading in pathological diagnosis

目的探讨数字化阅片在临床病理诊断中的可重复性和正确率。方法选取成都市第一人民医院病理科于2015年9月诊断的300例连续组织学病例作为研究对象,将所有病理切片运用全切片图像扫描技术(WSI)进行数字化扫描;再分别于2015年11月、2016年1月、2016年3月再次阅片后做出第一次数字化诊断、第二次显微镜诊断及第二次数字化诊断;最后对不同时间用不同方式诊断的四次结果进行比较,分析数字化阅片在临床病理诊断中的可重复性和正确率。结果同显微镜诊断一样,数字化诊断在病变性质及种类上均有很高的可重复性和正确率;同第一次数字化诊断与显微镜诊断的符合率比较,第二次数字化诊断与显微镜诊断的符合率明显升高;无论是显微镜阅片还是数字化阅片,对疑难病例复诊的正确率均高于初诊。结论数字化阅片在临床病理诊断中有很高的可重复性和正确率。随着病理医师对数字化阅片的逐渐适应,数字化诊断会越来越贴近、甚至超越显微镜诊断的可重复性和正确率。

Objective To investigate the repeatability and correctness of digital reading in clinical pathological diagnosis.Methods A total of 300 consecutive cases in Pathology Department of Chengdu First People′s Hospital diagnosed in September 2015 were chosen as research objects and all the slices were applied with digital scanning by whole slide images(WSI).The author reviewed slices again and made the first digital diagnosis,the second microscopic diagnosis,the second digital diagnosis separately in November 2015,January 2016 and March 2016.The four diagnosis results at different times and in different ways were compared,and the repeatability and correctness of digital reading in clinical pathological diagnosis was analyzed.Results Just as microscopic diagnosis,digital diagnosis had high repeatability and correctness in the nature and types of lesions.Compared with the coincidence rate of the first digital diagnosis and microscopic diagnosis,the coincidence rate of the second digital diagnosis and microscopic diagnosis was significantly higher.Whether it was microscopic or digital reading,the correctness of re-diagnosis of difficult cases was higher than that of initial diagnosis.Conclusion Digital reading has high repeatability and correctness in clinical pathological diagnosis.With the gradual adaptation of pathologists to digital reading,digital diagnosis will be more and more close to,or even beyond microscopic diagnosis in the repeatability and correctness.