乳腺病理报告中的决策:临床相关值的影响
Zeynep E Kain1, Ximena Baez-Navarro1, Sabine C Linn2
1Department of Pathology, Erasmus MC, Rotterdam, the Netherlands.
Histopathology
|November 11, 2025
概括
病理学家调整乳腺癌 (BC) 瘤大小和受体状态,在关键值周围报告. 这种做法,特别是避免1.0和2.0厘米的瘤大小,可能会影响分期和治疗决策.
科学领域:
- 在瘤学瘤学.
- 病理学 病理学 病理学
- 生物统计学 生物统计学
背景情况:
- 乳腺癌 (BC) 的临床决策对临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床临床
- 诸如瘤大小和受体状态之类的病理变量可能会受到解释,这可能会影响患者的分期和治疗.
- 了解病理学家围绕这些切线的决策对于准确的BC管理至关重要.
研究的目的:
- 调查病理学家如何解释和报告瘤大小和雌激素受体 (ER) /孕激素受体 (PgR) 状态,围绕乳腺癌临床显著的切断值.
- 识别报告中可能出现的潜在偏差或模式,这些偏差或模式可能源于接近这些值.
主要方法:
- 使用来自荷兰国家病理学登记处 (2014-2022) 的现实数据,对原发性侵袭性乳腺癌 (BC) 标本进行了回顾性分析.
- 包括大量BC患者的瘤直径和ER/PgR状态数据.
- 统计分析以确定报告测量的圆形化模式和值规避.
主要成果:
- 对64,099个BCs的分析显示,瘤直径的圆到最近的一半或整厘米,避免小瘤的1.0和2.0厘米门.
- 对于74,502个BC的ER/PgR评估,圆形化发生在低表达的5%的倍数.
- 病理学家倾向于将10%的ER/PgR切线附近的值报告为9%或11%,通常将瘤归类为仅仅阳性.
结论:
- 病理学家的报告实践受到瘤大小和乳腺癌中ER/PgR表达的临床相关切断值的影响.
- 观察到避免特定瘤大小值 (1.0和2.0厘米) 和倾向于将瘤归类为阳性在10%的ER/PgR标志附近的趋势需要进一步调查.
- 这些报告趋势对乳腺癌治疗决策的影响需要进一步研究.
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