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Often cytotechnicians have more accurate diagosis. It is a pressure for pathologists to change cytotechnicans' interpretation. Of cause cytotech often over call. It is not a problem for cytotech to over call, but it is problem for them to low call or miss call.(通常细胞技术员会诊断得更准确,病理医生更改技术员的结果时面临很大的压力。当然技术员经常过诊,对技术员来说过诊没有关系,但是低诊或漏诊是大问题。)
这是赵老师在一个病例中提到的一个现象,我为什么要引用到这里呢?其实在我们论坛里常常会出现一个现象:追求跟活检结果的符合率,以为符合率越高越好?事实不是这样的,宫颈细胞学筛查,筛查的目的是不要漏掉有临床处理意义的病例;不是代替组织学作为临床处理诊断的指南或金指标。我想喻老师这样的来分析这个病例的目的,就是告诉大家作为病理医生最重要的是给临床一个好的处理参考,同时小心过叫导致的过诊断和过治疗。
以下是引用如风如雪在2010-1-21 16:26:00的发言:
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以下是引用mingfuyu在2010-1-21 8:59:00的发言: ASCUS or ASC-H. To me, only the 2 cells in left lower photo are suspicious for HSIL, but the nuclei are too dark and i cannot see the chromatin pattern. Irregular nuclear contour can also be caused by artifact. Other cells are metaplastic or atypical metaplastic cells and parakerototic or atypical parakeratotic cells, should be in ASCUS category. |