肿瘤病理诊断与临床诊断不一致成因分析

目的研究肿瘤患者病理诊断与临床诊断之间不一致的发生率、成因及对患者的影响。方法收集安徽医科大学第二附属医院肿瘤中心1275例住院患者的临床资料,通过病理会诊及临床随访判断病理诊断与临床诊断的一致性。分析不一致的成因和对患者的影响。结果 65例(5.3%)病理诊断与临床诊断不一致。病理诊断与临床诊断不一致原因:取材不当36例(55.4%)、病变复杂22例(33.9%)、病理医生的经验6例(9.2%)和提供病史不完整1例(1.5%)。分别对比不同级别医院获得的病理诊断与临床诊断一致性的差异(P0.05)、不同病变部位病理诊断与临床诊断一致性的差异(P0.05),均有统计学意义。结论病理诊断与临床诊断之间不一致真实存在。临床医生应正确看待病理诊断,并且将病理诊断结果与临床特点、影像学结果综合分析,以得到最为准确的诊断。

Causes of pathology error in tumor patients

Objective To study the incidence,causes and effect of pathology error in tumor patients.Meth-ods A total of 1226 cases of tumor were observed.The pathological diagnoses in 65 cases were discrepant with clini-cal diagnosis through pathology consultation and clinical follow-up.The causes of pathology error and the effect on the patients were analyzed.Results There were 65 cases which pathologic diagnosis was not consistent with the clinical diagnosis.The causes included sampling in 36 cases (55.4%),lesions complex in 22 cases (33.9%),experience of pathologist in 6 cases (9.2%)and typographic error in 1 case (1.5%).The number of the pathology error was related to the level of hospital and the location of the lesion.Conclusion The discordance of pathologic diagnosis and clinical diagnosis does exist.Clinicians should be aware of the limitations of pathological diagnosis in work,and combine the results of pathological diagnosis and clinical characteristics and imaging results,in order to get the high-est accurate diagnosis.