DOI QR코드

DOI QR Code

Practical Understanding of Gross Examination Techniques

육안검사기술의 실무적 이해

  • Received : 2024.02.19
  • Accepted : 2024.02.29
  • Published : 2024.03.31

Abstract

Gross examination techniques (GETs) of specimens collected from cancer surgery or endoscopy comprise the act of recording visual information about cancer for accurate histopathological diagnosis and collecting sections of the lesion to create microscopic specimens. GETs must include concise and accurate expressions, appropriate structuring, sufficient resections, error-free standardization of important information, and photo-diagramming of complex specimens. To increase the satisfaction of pathological interpretation, it is a task that must be performed accurately and carefully to gain confidence on a theoretical and practical basis with a sufficient understanding of gross examination. Based on the experience of clinical pathologists in the field of GETs, additional specimen types should be identified as viable candidates. Also, their needs and concerns regarding treatment should be carefully considered. In addition, departments at each institution should review the national focus on clinical partnerships, continuous professional training, diagnostic errors, and value-based healthcare provision.

육안검사는 정확한 병리조직학적 진단을 위해 수술, 내시경 검사에서 채취된 검체를 육안검사를 통해 암의 육안정보를 기록하고 병변은 현미경 표본을 만들기 위해 절편을 채취하는 행위이다. 육안검사의 기술은 간결하고 정확한 표현, 적절한 구조화, 충분한 절제, 중요정보에 대한 오류가 없는 표준화, 복잡한 검체의 사진 도표화가 이루어져야 한다. 병리학적 판독의 만족도를 높이기 위해서는 육안검사에 대한 이해가 충분한 이론적 실무적 바탕에서 신뢰를 얻기 위한 정확하고 신중히 수행해야 하는 업무이다. 육안검사 분야에서 임상병리사들의 경험을 바탕으로, 추가 표본 유형이 실행 가능한 후보로 식별되고 치료 측면에서 요구와 우려 사항을 신중하게 고려해야 한다. 또한, 각 기관의 부서에서는 임상과의 파트너쉽, 지속적인 전문인력 양성, 진단오류 및 가치 기반의 의료제공에 대한 국가적 초점 측면에서 검토해야 할 것이다.

Keywords

Acknowledgement

This paper was supported by the Korean Association of Medical Technologists in 2024 and Proceeded by support project for thesis submission by member practitioners. Proofreading performed by Park CE.

References

  1. Wright JR Jr. The American college of surgeons, minimum standards for hospitals, and the provision of high-quality laboratory services. Arch Pathol Lab Med. 2017;141:704-717. https://doi.org/10.5858/arpa.2016-0348-HP 
  2. Bennett A, Garcia E, Schulze M, Bailey M, Doyle K, Finn W, et al. Building a laboratory workforce to meet the future: ASCP task force on the laboratory professionals workforce. Am J Clin Pathol. 2014;141:154-167. https://doi.org/10.1309/AJCPIV2OG8TEGHHZ 
  3. Geller SA, Horowitz RE. Gross examination. Methods Mol Biol. 2014;1180:3-19. https://doi.org/10.1007/978-1-4939-1050-2_1 
  4. Gunay S, SaritasYuksel E, Topal F, Pakoz B, Cekic C, Camyar H, et al. Dissection of mucosa and muscularis mucosa instead of submucosal dissection: rapid retroflow of the injection fluid can be an indicator. Endoscopy. 2021;53:E122-E123. https://doi.org/10.1055/a-1216-0448 
  5. Kouyama Y, Kudo SE, Miyachi H, Ichimasa K, Hisayuki T, Oikawa H, et al. Practical problems of measuring depth of submucosal invasion in T1 colorectal carcinomas. Int J Colorectal Dis. 2016;31:137-146. https://doi.org/10.1007/s00384-015-2403-7 
  6. Tang XY, Huang MX, Han SQ, Chang Y, Li ZP, Kao XM, et al. The circumferential resection margin is a prognostic predictor in colon cancer. Front Oncol. 2020;10:927. https://doi.org/10.3389/fonc.2020.00927 
  7. Okada S, Hattori A, Matsunaga T, Takamochi K, Oh S, Inoue M, et al. Prognostic value of visceral pleural invasion in pure-solid and part-solid lung cancer patients. Gen Thorac Cardiovasc Surg. 2021;69:303-310. https://doi.org/10.1007/s11748-020-01470-8 
  8. Seok Y, Jeong JY, Lee E. Extent of visceral pleural invasion and the prognosis of surgically resected node-negative non-small cell lung cancer. Thorac Cancer. 2017;8:197-202. https://doi.org/10.1111/1759-7714.12424 
  9. Patel SH, Hu CY, Massarweh NN, You YN, McCabe R, Dietz D, et al. Circumferential resection margin as a hospital quality assessment tool for rectal cancer surgery. J Am Coll Surg. 2020;230:1008-1018.e5. https://doi.org/10.1016/j.jamcollsurg.2020.02.033 
  10. Quezada-Diaz FF, Smith JJ. Neoadjuvant therapy for rectal cancer. Surg Oncol Clin N Am. 2022;31:279-291. https://doi.org/10.1016/j.soc.2021.11.008 
  11. Zakka FR, Cipriani NA. To freeze or not to freeze? Recommendations for intraoperative examination and gross prosection of thyroid glands. Surg Pathol Clin. 2023;16:15-26. https://doi.org/10.1016/j.path.2022.09.004