Ku N N, Cox C E, Reintgen D S, Greenberg H M, Nicosia S V
Department of Pathology, University of South Florida Health Sciences Center, Tampa 33612.
Acta Cytol. 1991 Jul-Aug;35(4):417-21.
Residual microscopic disease after lumpectomy may cause significant local recurrence. This study evaluated the use of touch preparation cytology to assess lumpectomy margins. For 90 specimens, the findings on Diff-Quik-stained touch preparations (rendered intraoperatively within 15 minutes after the lumpectomy) were correlated with the gross findings, frozen-section results and, later, the findings in the permanent histologic sections. Three specimens were cytologically unsatisfactory, 68 yielded benign findings, and 19 were suspicious or diagnostic for malignancy. The margins showed tumor involvement in 5 lumpectomy samples by gross examination, in 13 by frozen-section evaluation and in 17 by the study of permanent sections. Touch preparation cytology was putatively falsely positive in two cases while frozen-section evaluation was falsely negative in four cases. Cytology had a sensitivity of 100%, a specificity of 97.1% and a diagnostic accuracy of 97.7%. These results demonstrate that touch preparation cytology rapidly and reliably evaluates lumpectomy margins and can overcome some sampling errors and artifacts related to frozen-section analysis. Touch preparation cytology is now being used to complement frozen-section evaluation of lumpectomy margins as part of a protocol aimed at reducing the local recurrence rate.
乳房肿块切除术后残留的微小病灶可能导致显著的局部复发。本研究评估了触片细胞学检查在评估乳房肿块切除切缘中的应用。对于90个标本，Diff-Quik染色触片（在乳房肿块切除术后15分钟内术中制作）的结果与大体检查结果、冰冻切片结果以及随后的永久组织学切片结果进行了关联。3个标本细胞学检查结果不满意，68个显示良性结果，19个对恶性肿瘤可疑或诊断为恶性肿瘤。大体检查显示5个乳房肿块切除标本的切缘有肿瘤累及，冰冻切片评估显示13个有肿瘤累及，永久切片研究显示17个有肿瘤累及。触片细胞学检查在2例中被推测为假阳性，而冰冻切片评估在4例中为假阴性。细胞学检查的敏感性为100%，特异性为97.1%，诊断准确性为97.7%。这些结果表明，触片细胞学检查能快速、可靠地评估乳房肿块切除切缘，并可克服一些与冰冻切片分析相关的采样误差和假象。作为旨在降低局部复发率方案的一部分，触片细胞学检查现正用于补充乳房肿块切除切缘的冰冻切片评估。
