Basten O, Bandorski D, Bismarck C, Neumann K, Fisseler-Eckhoff A
Institut für Pathologie und Zytologie, Neue Kasseler Str. 23a, 35039 Marburg.
Pathologe. 2010 May;31(3):218-24. doi: 10.1007/s00292-009-1256-7.
Lymph node staging is the most important prognostic parameter in malignant gastrointestinal tumors. Manual dissection of adipose tissue is time-consuming and also depends on the experience of the individual examiner. By combining elution with acetone and mechanical compression using simple equipment it was possible to completely embed adipose tissue from 404 surgical specimens (colon 348, stomach 28, greater omentum 14, other location 14) without manual dissection. As a result of the procedure, the weight of the adipose tissue could be reduced by 90%-95%, making full histological examination possible. The colon specimens included an average of 43.8 lymph nodes (14-109) in 14 embedding cassettes (1-38) with a native fat weight of 234.7 g (42.8-820 g). The quality of histological staining, including immunohistochemical and molecular investigations, is of comparable quality to routine work-up. Elution with acetone enables the prompt, standardized and full histological work-up of adipose tissue without manual dissection. Moreover, additional costs are low. The number of lymph nodes required by medical associations was attained in all cases and often exceeded. This method was successfully used in other organs (greater omentum, breast).
淋巴结分期是恶性胃肠道肿瘤最重要的预后参数。手动解剖脂肪组织既耗时,还取决于个体检查者的经验。通过将丙酮洗脱与使用简单设备进行机械压缩相结合,无需手动解剖就能完全包埋来自404个手术标本(结肠348个、胃28个、大网膜14个、其他部位14个)的脂肪组织。经过该操作,脂肪组织的重量可减少90%-95%,从而能够进行全面的组织学检查。结肠标本在14个包埋盒(1-38个)中平均包含43.8个淋巴结(14-109个),天然脂肪重量为234.7克(42.8-820克)。组织学染色的质量,包括免疫组织化学和分子研究,与常规检查相当。丙酮洗脱能够在无需手动解剖的情况下迅速、标准化且全面地对脂肪组织进行组织学检查。此外,额外成本较低。所有病例均达到并常常超过医学协会要求的淋巴结数量。该方法已成功应用于其他器官(大网膜、乳腺)。