Vol 9: Use of a standardized diagnostic approach improves the prognostic information of histopathologic factors in pancreatic and periampullary adenocarcinoma.Reportar como inadecuado



 Vol 9: Use of a standardized diagnostic approach improves the prognostic information of histopathologic factors in pancreatic and periampullary adenocarcinoma.


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This article is from Diagnostic Pathology, volume 9.AbstractBackground: Variability in reported histopathology parameters in operated periampullary adenocarcinomas may affect the prognostic weight of the parameters. Standardized axial sectioning produces a higher incidence of involved margins and also seems to produce a lower relative incidence of pancreatic compared with distal bile duct origin and a higher incidence of involved lymph nodes, compared with non-standardized procedure. The aims of this study were to 1 assess how a previously not described standardized pathology procedure, with longitudinal sectioning along the distal bile duct, affects reported tumour origin, margin status and involved lymph nodes, compared with non-standardized procedure, 2 assess if re-evaluation of microscopic slides affects the prognostic value of margin status and 3 compare the results of this standardized procedure with reported results of other standardized and non-standardized procedures. Methods: One hundred seventy-five consecutive pancreaticoduodenectomy specimens with primary adenocarcinomas, operated during 2001 – 2011 at the University hospitals of Lund and Malmö, Sweden, were re-evaluated histologically, and parameters relevant for classification and prognosis were assessed, with 1 mm as a threshold for involved or uninvolved margins. Follow-up lasted until 31 December 2013. Five-year overall survival OS and hazard ratios HR were calculated for the margin status stated in the original reports and margin status after re-evaluation. Results: Compared with non-standardized cases n = 129, standardized cases n = 46 had more involved lymph nodes in the specimens median 3 vs 1, a higher fraction of distal bile duct origin 39% vs 21% and a higher fraction of involved margins 74% vs 47%. The prognostic value of uninvolved margins increased by re-evaluation of slides p 



Autor: Elebro, Jacob; Jirstrom, Karin

Fuente: https://archive.org/







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