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The Accuracy of pHH3 in Meningioma Grading: A Single Institution Study pHH3 在脑膜瘤分级中的准确性:单机构研究
Pub Date : 2024-03-26 DOI: 10.29328/journal.apcr.1001041
N. Mansouri, R. Yaiche, Khouloud Takout, F. Gargouri, Karima Tlili, Amine Rachdi Mohamed, Hichem Ammar, Dahmani Yedeas, K. Radhouane, R. Chkili, Issam Msakni, Besma Laabidi
Introduction: In the latest WHO classification of central nervous system tumors, Mitotic Index (MI) counted on Phosphohistone-H3 stained slides (pHH3-MI) has been suggested as a valid proliferative marker in various tumors including in the evaluation of meningioma grading. We aim to report our own experience in assessing the efficiency of the anti-pHH3 antibody as a grading tool for meningiomas. Methods: A retrospective study was conducted on a series of 40 meningiomas diagnosed from March 2020 to April 2021 at the Pathology Department of the Military Hospital of Tunis. We attempted immunohistochemistry and compared MI assessed on both pHH3 and HE-stained slides. Results: According to the HE-MI and pHH3-MI, the 40 cases of meningiomas were respectively divided into 35 versus 29 grade 1 cases, four versus eight grade 2 cases, and one versus three grade 3 cases. A highly significant correlation was found between pHH3-MI and HE-MI (p < 0.001). A significantly higher sensitivity in the pHH3 counting method was reported in our study. Discussion: we found, in accordance with the literature, that pHH3-MI is more reliable and accurate in mitotic counting, therefore exhibiting a high sensitivity in tumor grading, reported by an upgrade within 22,5% of the cases. Conclusion: PHH3-MI count facilitated a rapid reliable grading of meningiomas. However, molecular characteristics that could have a potentially significant impact on tumor progression should be the subject of further research.
导言:在世界卫生组织最新的中枢神经系统肿瘤分类中,磷脂酰-H3染色切片上的有丝分裂指数(MI)(pHH3-MI)被认为是各种肿瘤(包括脑膜瘤分级评估)的有效增殖标志物。我们旨在报告自己在评估抗 pHH3 抗体作为脑膜瘤分级工具的效率方面的经验。研究方法我们对 2020 年 3 月至 2021 年 4 月期间在突尼斯军事医院病理科确诊的 40 例脑膜瘤进行了回顾性研究。我们尝试了免疫组化,并比较了 pHH3 和 HE 染色切片上评估的 MI。结果:根据 HE-MI 和 pHH3-MI,40 例脑膜瘤分别分为 35 对 29 例 1 级病例、4 对 8 例 2 级病例和 1 对 3 例 3 级病例。pHH3-MI 与 HE-MI 之间存在高度相关性(p < 0.001)。在我们的研究中,pHH3 计数方法的灵敏度明显更高。讨论:我们发现,与文献报道一致,pHH3-MI 在有丝分裂计数方面更可靠、更准确,因此在肿瘤分级方面表现出较高的灵敏度,22.5% 的病例可通过该方法进行分级。结论PHH3-MI 计数有助于对脑膜瘤进行快速、可靠的分级。然而,对肿瘤进展有潜在重大影响的分子特征应成为进一步研究的主题。
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引用次数: 0
Harmonizing Artificial Intelligence Governance; A Model for Regulating a High-risk Categories and Applications in Clinical Pathology: The Evidence and some Concerns 协调人工智能治理;高风险类别监管模式及在临床病理学中的应用:证据和一些担忧
Pub Date : 2024-03-18 DOI: 10.29328/journal.apcr.1001040
Omabe Maxwell
The Canadian healthcare system, grappling with issues like systemic and intelligently established structural anti-black racism, including indigenous nations; even within Pathology and Laboratory Medicine Communities: and deteriorating outcomes, sees potential in AI to address challenges, though concerns exist regarding exacerbating discriminatory practices. In clinical pathology, AI demonstrates superior diagnostic accuracy compared to pathologists in a study, emphasizing its potential to improve healthcare. However, AI governance is crucial to navigating ethical, legal, and societal concerns. The Royal College of Physicians of Canada acknowledges the transformative impact of AI in healthcare but stresses the need for responsible AI tools co-developed by diverse teams. Despite positive attitudes towards AI in healthcare, concerns about patient safety, privacy, and autonomy highlight the necessity for comprehensive education, engagement, and collaboration. Legal concerns, including liability and regulation, pose challenges, emphasizing the need for a robust regulatory framework. AI application in healthcare is categorized as high-risk, demanding stringent regulation to ensure safety, efficacy, and fairness. A parallel is drawn to drug regulation processes, suggesting a similar approach for AI. The lack of transparency in AI-based decision-making raises ethical questions, necessitating measures to address biases and ensure patient privacy. Social accountability is crucial to prevent AI from exacerbating health disparities and harming marginalized communities. In conclusion, while AI offers potential benefits in clinical pathology, a cautious approach with comprehensive governance measures is essential to mitigate risks and ensure ethical AI integration into healthcare.
加拿大的医疗保健系统正努力解决系统性和智能化的结构性反黑人种族主义(包括土著民族)、甚至病理学和实验室医学社区内部的反黑人种族主义以及不断恶化的治疗效果等问题,尽管存在加剧歧视性做法的担忧,但人工智能仍有潜力应对这些挑战。在临床病理学方面,一项研究显示,与病理学家相比,人工智能的诊断准确性更胜一筹,强调了其改善医疗保健的潜力。然而,人工智能的管理对于解决伦理、法律和社会问题至关重要。加拿大皇家医学院承认人工智能在医疗保健领域的变革性影响,但强调需要由不同团队共同开发负责任的人工智能工具。尽管人们对医疗保健领域的人工智能持积极态度,但对患者安全、隐私和自主权的担忧凸显了全面教育、参与和合作的必要性。包括责任和监管在内的法律问题带来了挑战,强调了建立健全监管框架的必要性。人工智能在医疗保健领域的应用被归类为高风险,需要严格的监管以确保安全性、有效性和公平性。这与药品监管流程相似,表明人工智能也需要类似的监管方法。基于人工智能的决策缺乏透明度,这就提出了伦理问题,需要采取措施消除偏见并确保患者隐私。社会问责制对于防止人工智能加剧健康差距和伤害边缘化群体至关重要。总之,虽然人工智能为临床病理学带来了潜在的益处,但必须采取谨慎的方法和全面的管理措施,以降低风险并确保人工智能融入医疗保健的伦理道德。
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Archives of pathology and clinical research
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