线上交互式培训在提高内镜医师胰腺内镜超声引导下细针抽吸术细胞病理诊断能力中的价值
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1.南京大学医学院附属鼓楼医院消化内科;2.南京大学医学院附属鼓楼医院病理科

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基金项目:

江苏省自然科学基金面上项目(SBK2019022491);南京市医学科技发展项目(ZKX18022,YKK17077)


Value of an online interactive training program for improving cytopathological diagnostic ability of endoscopists in endoscopic ultrasound⁃guided fine⁃needle aspiration of pancreas
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Affiliation:

Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School

Fund Project:

Jiangsu Natural Science Foundation (SBK2019022491); Nanjing Medical Science and Technology Development Project (ZKX18022, YKK17077)

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    摘要:

    目的 开发线上交互式细胞病理读片培训方案,并评估该方案在提高内镜医师胰腺内镜超声引导下细针抽吸术(endoscopic ultrasound⁃guided fine⁃needle aspiration,EUS⁃FNA)细胞病理诊断能力中的价值。方法 纳入2018年8月—2019年8月在南京鼓楼医院消化内科行EUS⁃FNA的194例胰腺实性占位患者的细胞刷片,从中共采集5 500张细胞病理图片,由高年资细胞病理医师对每张图片中的细胞类别进行标注,用于搭建线上交互式细胞病理读片培训学习和测试平台。5名无病理基础的内镜医师受邀参与本培训,比较培训前后内镜医师鉴别诊断癌和非癌的敏感度、特异度、阳性预测值和阴性预测值,评价线上交互式细胞病理读片培训方案在提高内镜医师细胞病理诊断能力中的作用。结果 本研究成功搭建供内镜医师线上学习和测试的交互式细胞病理读片培训平台。培训前内镜医师诊断癌和非癌的敏感度、特异度、阳性预测值、阴性预测值及准确率分别为0.55(95%CI:0.53~0.58)、0.32(95%CI:0.30~0.35)、0.43(95%CI:0.41~0.45)、0.44(95%CI:0.41~0.47)和0.43(95%CI:0.42~0.45)。经过培训,以上指标分别为0.96(95%CI:0.95~0.97)、0.70(95%CI:0.68~0.73)、0.74(95%CI:0.72~0.76)、0.95(95%CI:0.94~0.96)和0.81(95%CI:0.80~0.83),较培训前均得到显著提升(P<0.001)。结论 线上交互式细胞病理读片培训方案可提高内镜医师对胰腺细胞病理的认识水平和诊断能力,有助于内镜医师在EUS⁃FNA过程中实施快速现场评估,提高EUS⁃FNA的诊断效能。

    Abstract:

    Objective To develop an online interactive cytopathological training program, and to evaluate it for improving the cytopathological diagnostic ability of endoscopists in endoscopic ultrasound⁃guided fine⁃needle aspiration (EUS⁃FNA) of pancreas. Methods A total of 5 500 cytopathological images were collected from 194 patients with pancreatic solid mass who underwent EUS⁃FNA in Nanjing Drum Tower Hospital from August 2018 to August 2019. The cell type in each cytopathological picture was labeled by senior cellular pathologists, which was used to build a learning and testing platform for online interactive cytopathological training. Five endoscopists without cytopathological background were invited to participate in this training. Sensitivity, specificity, positive predictive value and negative predictive value of endoscopists in differential diagnosis of cancer and non⁃cancer before and after training were compared to evaluate the effect of the online interactive cytopathological training program on improving the ability of endoscopists in diagnosis of cytopathology. Results A cytopathological training platform for endoscopists to learn and take online test was successfully built. Before training, sensitivity, specificity, positive predictive value, negative predictive value and accuracy of diagnosis of cancer and non⁃cancer for endoscopists were 0.55 (95%CI: 0.53⁃0.58), 0.32 (95%CI: 0.30⁃0.35), 0.43 (95%CI: 0.41⁃0.45), 0.44 (95%CI: 0.41⁃0.47) and 0.43 (95%CI: 0.42⁃0.45), respectively. After training, the above indicators were 0.96 (95%CI: 0.95⁃0.97), 0.70 (95%CI: 0.68⁃0.73), 0.74 (95%CI: 0.72⁃0.76), 0.95 (95%CI: 0.94⁃0.96) and 0.81 (95%CI: 0.80⁃0.83), respectively, which were significantly improved compared with those before (P<0.001). Conclusion The online interactive cytopathological training program can improve the understanding and diagnostic ability of endoscopists in pancreatic cytopathology, help to implement rapid on⁃site evaluation in the process of EUS⁃FNA, and improve the diagnostic efficiency of EUS⁃FNA.

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张松,郑金榆,柏涛,等.线上交互式培训在提高内镜医师胰腺内镜超声引导下细针抽吸术细胞病理诊断能力中的价值[J].中华消化内镜杂志,2022,39(8):628-634.

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  • 收稿日期:2021-05-28
  • 最后修改日期:2022-05-31
  • 录用日期:2021-07-05
  • 在线发布日期: 2022-06-02
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