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根治性前列腺切除术中冰冻切片活检的价值:组织学结果的意义

Value of frozen section biopsies during radical prostatectomy: significance of the histological results.

作者信息

Ramírez-Backhaus Miguel, Rabenalt Robert, Jain Sunjay, Do Minh, Liatsikos Evangelos, Ganzer Roman, Horn Lars-Christian, Burchardt Martin, Jiménez-Cruz Fernando, Stolzenburg Jens-Uwe

机构信息

Servicio de Urología Hospital Universtario La Fe, Avenida Campanar 21, 46009, Valencia, Spain.

出版信息

World J Urol. 2009 Apr;27(2):227-34. doi: 10.1007/s00345-008-0360-2. Epub 2008 Dec 10.

Abstract

PURPOSE

To review the evidence about frozen sections during radical prostatectomy (RP) and its ability to decrease the incidence of positive margins, the impact on PSA postoperatively and the significance of residual benign prostatic cells after prostatectomy.

METHODS

The information for this review was compiled by searching the Pubmed database. We used Mesh Terms "Prostatectomy" and "Prostatic Neoplasms" and we added "frozen sections" and/or "hyperplasic cells" and/or "benign cells" and/or "positive margins". Furthermore, we review the articles referenced in those studies and editorials letters.

RESULTS

Several groups have studied the performance of frozen section during RP to try and assess the risk of positive margins intraoperatively. The controversial sites where they should be performed are the apex, the dorsolateral zones and the bladder neck. They have been performed routinely or when the surgeon decides it, depending on the preoperative or intraoperative findings.

CONCLUSIONS

At the present time there is no standardisation in the number, the site and the type of patient where this procedure should be done. The improvement in functional outcomes and biochemical control is not proven.

摘要

目的

回顾有关根治性前列腺切除术(RP)中冰冻切片的证据,及其降低切缘阳性发生率的能力、对术后前列腺特异性抗原(PSA)的影响以及前列腺切除术后残留良性前列腺细胞的意义。

方法

本综述的信息通过检索PubMed数据库收集。我们使用医学主题词“前列腺切除术”和“前列腺肿瘤”,并添加了“冰冻切片”和/或“增生细胞”和/或“良性细胞”和/或“切缘阳性”。此外,我们还查阅了这些研究和社论信件中引用的文章。

结果

多个研究小组对RP术中冰冻切片的表现进行了研究,试图评估术中切缘阳性的风险。争议较大的应进行冰冻切片的部位是前列腺尖部、背外侧区和膀胱颈部。根据术前或术中发现,这些部位可常规进行冰冻切片,也可由外科医生决定是否进行。

结论

目前,该手术的数量、部位和适用患者类型尚无标准化。其对功能结局和生化控制的改善尚未得到证实。

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