Specimen management and pathological traceability
gastric cancers, neoplasia, gastric cancer, carcinoma, inflammation, atrophy, diganosis
GASTRIC CANCERS, NEOPLASIA, INFLAMMATION, CARCINOMA, INTESTINAL METAPLASIA, ATROPHY, PATHOLOGY, GASTRIC CANCER
After tissue sampling, the specimens that arrive in the pathology department will be dehydrated, embedded, sliced, and stained. Pathological results will be obtained from local study centres by expert pathologists at each centre. Regarding patients diagnosed with gastric cancers by biopsy and those highly suspected with gastric cancer without biopsy who will possibly take further elective operations, their pathological results of resected specimens will be traced for up to 60 days from their endoscopy date to determine the invasion depth of gastric cancer.After the training program, a group of five research assistants will watch the raw video of each participant and capture clean, high-quality frames of the lesions with pathological results under the guidance of an expert endoscopist. All images of the lesions and corresponding pathological results will be sent to an independent group of three expert endoscopists for further endoscopic evaluation. Randomisation and personal information will be concealed, and the experts will be unaware of the allocation of the lesions. A group of three experts will evaluate the endoscopic and pathological diganosis of a lesion and determine whether they are unmatched. (Here was a clerical error of describing the determination of the unmatched lesions, and we have corrected it). De-identified digital pathological slides of unmatched lesions will be sent to an independent group of expert pathologists for consultation. Only unmatched lesions will be reviewed by an independent group of expert pathologists for the final diagnosis.Each expert pathologist is required to determine whether the slide contains acute inflammation, chronic inflammation, atrophy, or intestinal metaplasia and to rate the severity (mild, moderate, or severe) of these pathological changes. In addition, they are required to determine the presence of low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia, or carcinoma. Multiple pathological changes may occur in the same lesion, the most severe being the primary diagnosis. The severity of the pathological changes increases from inflammation to carcinoma. A lesion is diagnosed only when two or more experts reach a consensus. If the three expert pathologists did not reach a consensus, the lesion was re-evaluated until a consensus was reached.