Cox C E, Ku N N, Reintgen D S, Greenberg H M, Nicosia S V, Wangensteen S
Department of Surgery, University of South Florida Health Sciences Center, H. Lee Moffitt Cancer Center, Tampa 33682-0179.
Arch Surg. 1991 Apr;126(4):490-3. doi: 10.1001/archsurg.1991.01410280094014.
Residual microscopic disease after lumpectomy for breast cancer may cause significant local recurrence. We evaluated one hundred fourteen consecutive breast lumpectomy margins in this study by touch preparation cytology. Cytologic preparations were intraoperatively correlated with gross and frozen section results and subsequently with permanent histologic sections of representative margins. Three specimens were cytologically unsatisfactory and 86 yielded benign findings, while material suggestive or diagnostic of malignancy was obtained from 25 specimens. Gross, frozen section, and permanent histologic margins were positive in 10, 17, and 22 cases, respectively. There were three false-positive touch preparation cytologic results, while frozen section specimens were false-negative in five cases. Sensitivity and specificity of touch preparation cytology were 100% and 96.6%, respectively, with a diagnostic accuracy of 97.3%. Touch preparation cytologic examination rapidly and reliably evaluates lumpectomy margins and overcomes sampling errors and artifacts related to frozen section evaluation. This technique currently complements frozen section evaluation of lumpectomy margins as part of a protocol aimed at reducing local recurrence of breast cancer.
乳腺癌肿块切除术后残留的微小病灶可能会导致显著的局部复发。在本研究中，我们通过触摸涂片细胞学检查评估了114例连续的乳腺肿块切除切缘。细胞学涂片在术中与大体标本及冰冻切片结果相关联，随后又与代表性切缘的永久组织学切片相关联。3份标本的细胞学检查结果不理想，86份标本显示良性结果，而25份标本获得了提示或诊断为恶性肿瘤的材料。大体标本、冰冻切片和永久组织学切缘分别在10例、17例和22例中呈阳性。触摸涂片细胞学检查有3例假阳性结果，而冰冻切片标本有5例假阴性结果。触摸涂片细胞学检查的敏感性和特异性分别为100%和96.6%，诊断准确性为97.3%。触摸涂片细胞学检查能快速、可靠地评估肿块切除切缘，克服了与冰冻切片评估相关的抽样误差和人为假象。作为旨在降低乳腺癌局部复发的方案的一部分，该技术目前补充了肿块切除切缘的冰冻切片评估。
