Causes and effects of pathology discrepancy in head and neck cancer patients-based on clinical evaluation

Objective To study the incidence, causes and effects of pathology discrepancy in head and neck cancer patients. Methods From August 2014 to April 2015 in the Second Affiliated Hospital of Anhui Medical University, 118 hospitalized patients with head and neck cancers were included in this study. The accuracy and absence of pathological diagnosis, discrepancy between clinical and pathological diagnosis and the prognosis of all the patients were assessed. The effects of discrepancy between pathological diagnosis and clinical diagnosis were categorized as follows: no harm, near miss, minimal harm, moderate harm and major harm. Results Among the 118 cases studied, there were 16 discrepancy between pathological diagnosis and clinical diagnosis. The causes of them include the underperforming pathologic sampling quality in 7 cases, complex pathological characteristics in 8 cases, experience of pathologist in 1 cases. Pathology error result in no harm was noted in 1 cases (6.3%). Near miss was observed in 3 cases (18.8%). Minimal harm was observed in 1 cases (6.3%), moderate harm was found in 11 cases (68.8%) while major harm was not modified. Conclusions The major reason of discrepancy between pathological diagnosis and clinical diagnosis are sampling and lesions complex (especially lymph node metastasis from unknown primary tumors and thyroid tumor). The large majority of diagnostic errors do not result in severe harm, and it depends on the experience of clinician.