Analysis of factors related to delay in pathology reporting / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the factors related to delay in pathology reporting and to improve the quality of pathology service.</p><p><b>METHODS</b>A total of 24 months pathology reports (total number = 21,038) issued by Department of Pathology, Dongyang People's Hospital (randomly selected during the period from 1999 to 2006) were analyzed. The timeliness of these reports was studied with respect to the types of specimens (biopsy versus surgical versus frozen section). The causes for delay in reporting were statistically analyzed.</p><p><b>RESULTS</b>Among all the cases studied, 19,579 reports were timely issued (timeliness rate = 93.06%), whereas 1459 reports were delayed (delay rate = 6.94%). Of the 1459 delayed reports, routine biopsy specimens accounted for 6.02% (665/11,052), surgical specimens for 7.26% (643/8858) and frozen section specimens for 13.39% (151/1128). The main causes for delay in reporting were technical (1158 cases or 79.37%), including requests of immunohistochemical staining, intradepartmental or external consultation, patient contact and discussion with requesting clinicians. Factors related to responsibility, such as inadequate clinical information in the pathology request forms, were identified in 301 cases (20.63%). The delay in reporting was mainly due to factors occurring within the pathology department (which accounted for 1048 cases or 71.83% (P < 0.05) and most were technical (1017 cases or 97.04%). Extradepartmental factors, mainly related to responsibility, were noted in 270 cases (65.69%, chi2 = 709.59, P < 0.05).</p><p><b>CONCLUSION</b>Factors related to delay in pathology reporting can be categorized into technical and responsibility. The former can be rectified by improvement of laboratory procedures, while the latter needs education of the personnel concerned.</p>

Detection of IgH gene rearrangement in B-cell non-Hodgkin's lymphoma and application of gel-scan method / 中华病理学杂志

<p><b>OBJECTIVE</b>To develop a protocol for gene rearrangement study in non-Hodgkin's lymphoma (NHL) by PCR-directed gel-scan method and to set up quantitative criteria for IgH gene rearrangement which can be applied in the follow up of lymphoma patients.</p><p><b>METHODS</b>IgH gene rearrangement studies were carried out in 96 cases of B-cell NHL. The detection rate of clonality was evaluated. Sixty-five cases of IgH gene rearranged cases proven by FR3A-directed PCR and PAGE and 8 cases of benign lymphoid tissues (5 cases of reactive lymphoid hyperplasia, 3 cases of chronic tonsillitis), 5 cases of normal peripheral blood mononuclear cells were analyzed by gel-scan method and the proportion of h1/h2 (heights of peak1 and peak2 of gel-scan) was calculated.</p><p><b>RESULTS</b>The detection rate of IgH gene clonality was up to 68% using primer FR3A in the 96 B-cell NHL cases. The detection rate was up to 61% using primer FR2A. With a combination of primers FR3A and FR2A, the detection rate increased to 83%. Gel-scan curve showed that the value of h1/h2 was greater than 3 in all the 65 cases with IgH gene rearranged. In the 8 benign lymphoid tissue cases showed h1/h2 < 1.5, 5 cases with normal peripheral blood mononuclear cells showed a bell-shaped curve.</p><p><b>CONCLUSIONS</b>In the gel-scan curve of gene rearrangement studies in non-Hodgkin's lymphoma samples, the value of h1/h2 greater than 3 represents a true clonal proliferation. The peaks with relative heights less than 1.5 may not be significant and likely represent polyclonal cell population. A value between 1.5 and 3 however requires clinical follow-up. The success rate of rearrangement studies in B-cell NHL can be increased by using a combination of primers FR3A and FR2A.</p>