Moehrle M, Breuninger H, Röcken M
Department of Dermatology, University Hospital, Eberhard-Karls-University, Tübingen, Germany.
J Eur Acad Dermatol Venereol. 2007 May;21(5):591-5. doi: 10.1111/j.1468-3083.2007.02187.x.
Complete three-dimensional histology of excised skin tumour margins has a long tradition and, unfortunately, a multitude of names as well. Mohs, who introduced it, called it 'microscopically controlled surgery'. Others have described it as 'micrographic surgery', 'Mohs' micrographic surgery', or simply 'Mohs' surgery'. Semantic confusion became truly rampant when variant forms, each useful in its own way for detecting subclinical outgrowths of malignant skin tumours, were later introduced under such names as histographic surgery, systematic histologic control of the tumour bed, histological control of excised tissue margins, the square procedure, the perimeter technique, etc. All of these methods are basically identical in concept. All involve complete, three-dimensional histological visualization and evaluation of excision margins. Their common goal is to detect unseen tumour outgrowths. For greater clarity, the authors of this paper recommend general adoption of '3D histology' as a collective designation for all the above methods. As an added advantage, 3D histology can also be used in other medical disciplines to confirm true R0 resection of, for example, breast cancer or intestinal cancer.
对切除的皮肤肿瘤边缘进行完整的三维组织学检查由来已久,不幸的是,它也有众多名称。引入该技术的莫氏(Mohs)将其称为“显微镜控制手术”。其他人则将其描述为“显微图像手术”“莫氏显微图像手术”或简称为“莫氏手术”。后来又引入了各种变体形式,如组织图像手术、肿瘤床的系统组织学控制、切除组织边缘的组织学控制、方形手术、周边技术等,每种形式都以自己的方式有助于检测恶性皮肤肿瘤的亚临床生长,这使得语义混淆变得十分猖獗。所有这些方法在概念上基本相同。都涉及对切除边缘进行完整的三维组织学可视化和评估。它们的共同目标是检测出肉眼看不见的肿瘤生长。为了更清晰起见,本文作者建议普遍采用“三维组织学”作为上述所有方法的统称。另外,三维组织学还可用于其他医学学科,以确认例如乳腺癌或肠癌的真正R0切除。