Analysis of clinical factors influencing pathologic diagnosis in lymphoma
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摘要: 目的 基于临床角度研究影响淋巴瘤病理诊断与临床诊断不一致的因素及其对治疗的影响。方法 收集我科2012年1月1日~2014年12月31日232例临床或病理诊断淋巴瘤患者的临床资料,研究淋巴瘤病理诊断与临床诊断不一致的原因及对治疗的影响。结果 结内淋巴瘤和弥漫大B细胞淋巴瘤病理诊断的可靠性分别高于结外淋巴瘤和非弥漫大B细胞淋巴瘤。不同取材方式对病理诊断可靠性也有影响,切除活检的肯定性病理报告率最高为73.7%。病理诊断与临床诊断不一致14例(6.0%),3例对治疗产生中度影响,剩余11例产生轻微影响。诊断差异主要与病变部位、取材方式及淋巴瘤病理类型有关。结论 淋巴瘤病理诊断与临床诊断不一致主要是淋巴瘤本身病理诊断即十分困难,此外病灶位置与取材方式也会影响病理诊断的可靠性,临床医生应与病理专家充分沟通,争取更准确的诊断。Abstract: Objective To explore factors influencing the discrepancy between clinical and pathological lymphoma diagnosis and their effects on the lymphoma treatment. Methods 232 hospitalized patients clinically or pathologically diagnosed with lymphoma between January 1st, 2012 and December 31st, 2014 were included in this study. The discrepancy between clinical and pathological diagnosis was assessed and the effects on the lymphoma treatment was evaluted. Results The diagnostic reliabilities of nodal lymphoma and diffuse large B-cell lymphoma were higher than those in extra-nodal lymphoma and non-diffuse large B cell lymphoma respectively. Reliability of pathological diagnosis was affected by diagnostic methods whereby the highest reliability incision biopsy could be 73.7%. There were 14(6.0%) inconsistent cases between clinical and pathological diagnosis, three cases resulted in moderate effects and 11 cases lead to mild effects on treatment. Inconsistencies were mainly due to lesion locations, different pathological diagnostic methods and pathological types of lymphoma. Conclusions The difficulty of lymphoma diagnosis, the locations and pathological diagnostic methods of lymphoma may contribute to the discrepancy between clinical and pathological diagnosis of lymphoma. Effective communication between clinicians and pathologist is required to get a more accurate diagnosis of lymphoma.
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Key words:
- Lymphoma /
- Diagnosis /
- Epidemiologic methods
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