gastric-pathology-specialist

name: gastric-pathology-specialist description: Comprehensive gastric cancer pathology workflow combining CAP/ICCR compliance validation, synoptic template generation, TNM staging (AJCC 8th edition), Lauren classification (intestinal/diffuse/mixed), WHO histologic typing, HER2 testing interpretation per ASCO/CAP, MSI/MMR status, tumor board summaries, and SNOMED coding. Use when the user uploads or pastes a gastric pathology report (total/subtotal gastrectomy, esophagogastrectomy, endoscopic submucosal dissection) and asks to "check gastric report", "validate CAP Stomach protocol", "stage this gastric cancer", "interpret Lauren classification", "interpret HER2 IHC/FISH", or any gastric-cancer-specific pathology task. Supports .pdf, .docx, .txt input in English and Turkish. license: MIT metadata: version: 1.3.0 author: Serdar Balci

Gastric Pathology Specialist

Complete gastric cancer pathology workflow toolkit combining compliance checking, staging, HER2 reporting, and coding.

When to Use This Skill

Use this skill for:

• Gastric cancer pathology report validation
• Gastric carcinoma specimens (gastrectomy, endoscopic resection)
• CAP/ICCR compliance checking with severity scoring
• TNM staging calculation (AJCC 8th edition)
• Lauren classification (intestinal/diffuse/mixed)
• WHO histologic typing
• HER2 testing interpretation (IHC/FISH)
• Tumor board summary generation
• SNOMED CT coding assistance

Supported Specimen Types

• Total gastrectomy
• Subtotal/partial gastrectomy
• Proximal gastrectomy
• Endoscopic mucosal resection (EMR)
• Endoscopic submucosal dissection (ESD)
• Wedge resection

Key Features

1. Compliance Checking: Validates against CAP Stomach and ICCR Gastric Carcinoma protocols
2. TNM Staging: AJCC 8th edition gastric cancer staging with pT/pN/M calculation
3. Lauren Classification: Intestinal, diffuse, mixed, or indeterminate type
4. WHO Typing: Tubular, papillary, mucinous, poorly cohesive, mixed adenocarcinoma
5. HER2 Reporting: IHC scoring (0/1+/2+/3+) and FISH interpretation per Trastuzumab guidelines
6. Template Generation: Gastrectomy and endoscopic resection synoptic templates
7. Tumor Board Summaries: Concise 3-5 line MDT presentation format
8. SNOMED Coding: Gastric-specific code suggestions

Reference Files

When processing reports, reference these files on-demand (DO NOT load at startup):

• Diagnosis guidelines: references/diagnosis/gastric_carcinoma.md
• Macroscopy guidelines: references/macroscopy/gastric_macroscopy.md
• TNM staging: ../../shared-references/staging/tnm_stage_calculator.md
• Synoptic templates: ../../shared-references/templates/synoptic_templates.md
• Biomarkers: ../../shared-references/biomarkers/BIOMARKERS_INDEX.md
• SNOMED codes: ../../shared-references/coding/snomed_ct_codes.md

Usage Examples

# Validate report compliance
claude "Check this gastric report using gastric-pathology-specialist" < report.txt

# Generate staging
claude "What stage is pT3 N2 M0 for gastric using gastric-pathology-specialist"

# Create template
claude "Generate total gastrectomy template using gastric-pathology-specialist"

# HER2 interpretation
claude "Interpret HER2 IHC 2+ and FISH ratio 2.3 using gastric-pathology-specialist"

Processing Instructions

When analyzing gastric pathology reports:

1. Identify request type (compliance check, staging, template, HER2 interpretation, summary, coding)
2. Read relevant reference file on-demand based on request
3. Process the report using appropriate guidelines
4. Generate output in requested format
5. DO NOT load all reference files upfront

Compliance Scoring

Use severity-based weighting:

• Critical elements (tumor size, grade, depth, margins, nodes, HER2): -15 points each
• Major elements (LVI, PNI, Lauren type, WHO type): -5 points each
• Minor elements (tumor location, distance from margins): -2 points each

Scoring: 90-100 (Compliant) | 70-89 (Minor issues) | 50-69 (Major issues) | <50 (Critical)

Cross-Validation Checks

Always validate:

• pT category vs invasion depth (mucosa/submucosa/muscularis propria/serosa)
• pN category vs positive node count
• Stage group vs pT/pN/M combination
• Margin status vs R classification
• HER2 IHC vs FISH correlation (2+ requires FISH)

Language Support

Supports English and Turkish - detect from user prompt and use appropriate template file.

Note: This is a minimal skill definition. Large reference files are loaded on-demand only when processing requests, not at skill startup.