骨髓质疏松性瘤的不一致的病理诊断及其对注册和治疗的含义
Edward J Gorak1, Michael Otterstatter2, Tareq Al Baghdadi3
1Division of Cancer Medicine, Baptist MD Anderson Cancer Center, Jacksonville, FL.
Blood advances
|August 8, 2023
概括
精确诊断骨髓质疏松性瘤 (MDS) 是一个挑战. 中央审查重新分类了三分之一的病例,突出了影响患者护理和登记的频繁诊断差异.
科学领域:
- 血液学 血液学 血液学
- 病理学 病理学 病理学
- 临床试验 临床试验
背景情况:
- 骨髓发育性瘤 (MDS) 包含各种血液形成疾病,预后和治疗方法各不相同.
- 正确的MDS病理诊断是很困难的,因为观察者之间的变异性在形态学和失育量化.
- 国家心脏,肺和血液研究所国家MDS自然历史研究是一项前性观察队列研究.
研究的目的:
- 为了比较本地临床场所的诊断与国家MDS自然历史研究参与者的中央评审.
- 为了确定疑似MDS或MDS/骨髓增殖性新生瘤 (MPN) 的本地和中央审查之间的诊断差异率.
- 评估诊断异常对治疗和注册表准确性的影响.
主要方法:
- 对918名参与者进行了诊断的中央评审.
- 地方临床诊断结果与中央审查结果进行了比较.
- 分析了参与者诊断,重新分类和治疗的数据.
主要成果:
- 大约三分之一的初始诊断在中央审查后被重新分类.
- 网站错误编码错误占当地误诊的半数以上.
- 真正的错误诊断率为整体15%,MDS为21%,不一致的诊断与较低的治疗率和不适当的治疗有关.
结论:
- 对于MDS和相关疾病的本地和中央审查之间存在频繁的诊断矛盾.
- 这些差异对研究记录的准确性和患者治疗有重大影响.
- 提高诊断准确度对于可靠的患者管理和流行病学研究至关重要.
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