背景:这项研究的目的是进行交叉检查,并在必要时,根据比利时癌症登记处(BCR)提供的神经胶质瘤患者病理报告中的发现,调整已登记的ICD-O-3地形图和形态学代码.此外,研究了分子标志物在病理诊断中的整合以及与WHO2016分类的一致性。
方法:由于有关分子测试和相应结论的信息不能作为人口水平的结构化数据获得,我们对已注册的神经胶质瘤患者(2017-2019年)进行了BCR提供的所有假名病理报告的人工筛查.来自BCR数据库的ICD-O-3形态学和地形代码(基于医院肿瘤护理计划和病理学实验室提供的信息),were,在肿瘤水平,与病理报告的数据交叉核对,如果需要,指定或更正。相关分子标记(IDH-1/2,1p19q共缺失,从病理报告中手动提取MGMTp)。
结果:在95,3%的神经胶质瘤中,ICD-O-3形态编码正确.在9.3%中指定了非特定地形代码,而3.3%的特定代码被纠正。在75,2%的星形细胞肿瘤中已知IDH状态。在不同的神经胶质瘤中,正确的综合诊断率从47,6%到56,4%不等。MGMTp甲基化状态在32,2%的胶质母细胞瘤中可用。
结论:病理报告结论中分子标记的整合以及这些报告向BCR的传递都可以得到改善。WHO分类中每个分子定义的肿瘤实体的不同ICD-O-3编码的可用性将增加癌症登记的一致性。促进人口水平研究和国际基准。
BACKGROUND: The objective of this study was to cross-check and, if necessary, adjust registered ICD-O-3 topography and morphology codes with the findings in pathology
reports available at the Belgian Cancer Registry (BCR) for glioma patients. Additionally, integration of molecular markers in the pathological diagnosis and concordance with WHO 2016 classification is investigated.
METHODS: Since information regarding molecular tests and corresponding conclusions are not available as structured data at population level, a manual screening of all pseudonymized pathology
reports available at the BCR for registered glioma patients (2017-2019) was conducted. ICD-O-3 morphology and topography codes from the BCR database (based on information as provided by hospital oncological care programmes and pathology laboratories), were, at tumour level, cross-checked with the data from the pathology
reports and, if needed, specified or corrected. Relevant molecular markers (IDH1/2, 1p19q codeletion, promoter region of the MGMT gene [MGMTp]) were manually extracted from the pathology reports.
RESULTS: In 95.3% of gliomas, the ICD-O-3 morphology code was correct. Non-specific topography codes were specified in 9.3%, while 3.3% of specific codes were corrected. The IDH status was known in 75.2% of astrocytic tumours. The rate of correct integrated diagnoses varied from 47.6% to 56.4% among different gliomas. MGMTp methylation status was available in 32.2% of glioblastomas.
CONCLUSIONS: Both the integration of molecular markers in the conclusion of the pathology
reports and the delivery of those
reports to the BCR can be improved. The availability of distinct ICD-O-3 codes for each molecularly defined tumour entity within the WHO classification would increase the consistency of cancer registration, facilitate population level research and international benchmarking.