Silapunt Sirunya, Peterson S Ray, Alcalay Joseph, Goldberg Leonard H
DermSurgery Associates, 7515 Main Street, Suite 240, Houston, TX 77030, USA.
Dermatol Surg. 2003 Nov;29(11):1109-12; discussion 1112.
Mohs micrographic surgery (MMS) is the most reliable, conservative, and tissue-sparing approach to the management of cutaneous malignancies. The concept of MMS is simple, but its technique, which involves a series of suboperations, is complex.
To define which techniques of Mohs tissue mapping and processing are presently employed by members of the American College of Mohs Micrographic Surgery and Cutaneous Oncology.
Five hundred eighty surveys of eight questions regarding different techniques used in Mohs tissue mapping and processing were mailed out to Mohs micrographic surgeons registered with the American College of Mohs Micrographic Surgery and Cutaneous Oncology. A total of 310 responses (53%) were collected between October and December 2002. The results were tabulated and analyzed.
Most Mohs micrographic surgeons personally prepare the map of the tissue in relationship to the patient (66.5%). A hand-drawn picture with standard orientations is most frequently used to map and orient a tissue specimen (69.4%). Histotechnicians usually prepare the tissue specimen for cryostat processing (63.5%). A heat extractor and/or tissue cuts or "slits" are the preferred methods used to flatten tissue by 52.9% of respondents. Hematoxylin and eosin is the stain that is most commonly used (82.6%). Approximately 50% of Mohs micrographic surgeons cut the excised specimen from the first stage into two separate pieces. Each tissue piece is then commonly processed into three to six representative serial sections per glass slide (68.1%). These sections are most commonly cut at 5 to 6 microm (53.9%) and less frequently at 4 microm (21.9%).
There is variability in mapping and processing techniques employed Mohs micrographic surgeons and their histotechnicians. As long as the integrity of each step of Mohs tissue mapping and processing is preserved, the high cure rate of the technique should be maintained.
莫氏显微外科手术（MMS）是治疗皮肤恶性肿瘤最可靠、最保守且最能保留组织的方法。MMS的概念很简单，但其技术涉及一系列子操作，较为复杂。
确定美国莫氏显微外科手术与皮肤肿瘤学会的成员目前采用哪些莫氏组织绘图和处理技术。
向在美国莫氏显微外科手术与皮肤肿瘤学会注册的莫氏显微外科医生寄出580份关于莫氏组织绘图和处理中使用的不同技术的八个问题的调查问卷。2002年10月至12月共收集到310份回复（53%）。对结果进行列表和分析。
大多数莫氏显微外科医生亲自绘制与患者相关的组织图谱（66.5%）。最常使用带有标准方向的手绘图片来绘制和确定组织标本的方向（69.4%）。组织技术人员通常为低温恒温器处理准备组织标本（63.5%）。52.9%的受访者首选热提取器和/或组织切割或“切口”来使组织变平。苏木精和伊红是最常用的染色剂（82.6%）。大约50%的莫氏显微外科医生将第一阶段切除的标本切成两块。然后通常将每个组织块在每张载玻片上处理成三到六个代表性的连续切片（68.1%）。这些切片最常切成5至6微米（53.9%），较少切成4微米（21.9%）。
莫氏显微外科医生及其组织技术人员在绘图和处理技术方面存在差异。只要莫氏组织绘图和处理的每个步骤的完整性得到保留，该技术的高治愈率就应能维持。
