肺病理学学会关于纤维化间质性肺病组织学诊断实践方法的调查:共识与机遇。

IF 3.7 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY
Maxwell L Smith, Mari Mino-Kenudson, Richard J Butterfield, Sanja Dacic, Thomas V Colby, Andrew Churg, Mary Beth Beasley, Lida P Hariri
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引用次数: 0

摘要

背景通常间质性肺炎(UIP)的病理诊断仍是一个具有挑战性的领域,UIP组织学指南的应用已被证明是困难的:了解肺病理学家目前对 UIP 和其他纤维化间质性肺病(ILDs)进行组织学诊断的实践方法:肺病理学会(PPS)ILD 工作组制定并通过电子方式向 PPS 会员发送了一份由 5 个部分组成的纤维化 ILD 调查:对 161 份完成的调查问卷进行了分析。在受访者中,89%的人表示在病理诊断中使用了特发性肺纤维化(IPF)临床指南中公布的组织学特征;但是,在报告术语、组织学特征的数量和质量以及指南分类的使用方面存在差异。受访者很有可能与肺病理学同行(79%)、肺病专家(98%)和放射科专家(94%)讨论病例。半数受访者表示,如果临床和放射病史相关,他们可能会根据其他病史改变病理诊断。以气道为中心的纤维化、肉芽肿和炎症浸润类型被认为很重要,但在如何定义这些特征方面意见不统一:PPS成员就UIP组织学指南/特征的重要性达成了重要共识。以下方面的需求尚未得到满足:(1) 诊断术语的共识和标准化,以及将临床 IPF 指南中推荐的组织病理学类别纳入病理报告;(2) 就如何将相关的临床和放射学信息纳入报告达成一致;(3) 界定建议替代诊断所需的特征的数量和质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pulmonary Pathology Society Survey on Practice Approaches in the Histologic Diagnosis of Fibrotic Interstitial Lung Disease: Consensus and Opportunities.

Context.—: The pathologic diagnosis of usual interstitial pneumonia (UIP) remains a challenging area, and application of histologic UIP guidelines has proved difficult.

Objective.—: To understand current practice approaches by pulmonary pathologists for the histologic diagnosis of UIP and other fibrotic interstitial lung diseases (ILDs).

Design.—: The Pulmonary Pathology Society (PPS) ILD Working Group developed and sent a 5-part survey on fibrotic ILD electronically to the PPS membership.

Results.—: One hundred sixty-one completed surveys were analyzed. Of the respondents, 89% reported using published histologic features in clinical guidelines for idiopathic pulmonary fibrosis (IPF) in their pathologic diagnosis; however, there was variability in reporting terminology, quantity and quality of histologic features, and the use of guideline categorization. Respondents were very likely to have access to pulmonary pathology colleagues (79%), pulmonologists (98%), and radiologists (94%) to discuss cases. Half of respondents reported they may alter their pathologic diagnosis based on additional clinical and radiologic history if it is pertinent. Airway-centered fibrosis, granulomas, and types of inflammatory infiltrates were considered important, but there was poor agreement on how these features are defined.

Conclusions.—: There is significant consensus among the PPS membership on the importance of histologic guidelines/features of UIP. There are unmet needs for (1) consensus and standardization of diagnostic terminology and incorporation of recommended histopathologic categories from the clinical IPF guidelines into pathology reports, (2) agreement on how to incorporate into the report relevant clinical and radiographic information, and (3) defining the quantity and quality of features needed to suggest alternative diagnoses.

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来源期刊
CiteScore
9.20
自引率
2.20%
发文量
369
审稿时长
3-8 weeks
期刊介绍: Welcome to the website of the Archives of Pathology & Laboratory Medicine (APLM). This monthly, peer-reviewed journal of the College of American Pathologists offers global reach and highest measured readership among pathology journals. Published since 1926, ARCHIVES was voted in 2009 the only pathology journal among the top 100 most influential journals of the past 100 years by the BioMedical and Life Sciences Division of the Special Libraries Association. Online access to the full-text and PDF files of APLM articles is free.
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