Department of Otolaryngology-Head and Neck Surgery, Centre hospitalier régional de lanaudiàre, St-Charles-Borromée, Quebec, Canada.
J Otolaryngol Head Neck Surg. 2010 Feb;39(1):12-9.
Positive margins for squamous cell carcinoma of the oral tongue on final pathology are a poor prognostic factor associated with a higher likelihood of local recurrence. Obtaining margin status in a relatively short time by using complete frozen sections, such as Mohs margins for skin cancer, would lower the recurrence rate. The goal of this study was to compare, on pig tongue, the efficacy of different techniques used to obtain complete frozen sections on histologic glass slides of optimal quality.
We compared the quality of frozen section glass slides on fresh pig tongues. The partial glossectomy was executed with either a sharp instrument (scalpel and scissors), electrocautery in the cutting mode, or electrocautery at the coagulation mode. For each of the three methods, we also compared the frozen section, obtained on the line of resection and for a thickness of 1 to 1.3 mm, using either the cryostat or isopentane for the freezing phase. The percentage and quality of epithelium and muscle present on histologic glass slides were assessed by a pathologist independently.
Complete frozen margins of high quality were obtained in a relatively short time for all techniques (28-38 minutes). Sharp dissection showed better results: a shorter processing time for the specimens and better quality for the histologic glass slides. Using cryostat or isopentane for the freezing phase did not show any significant difference.
Complete frozen margins (Mohs margins) of high quality are feasible. Histologic glass slides of very good quality are obtained when using a sharp dissection technique. For the freezing period, both isopentane and cryostat offer very good results. This approach is appropriate on animals and needs further study in clinical situations. The human experience will be presented in the next article which is: Complete frozen section margins (with measurable 1 or 5 mm thick free margin) for cancer of the oral tongue (Clinical experience Part 2 [CSO2008]).
口腔舌鳞癌最终病理的阳性切缘是预后不良的因素，与局部复发的可能性增加相关。通过使用完整的冷冻切片（如皮肤癌的 Mohs 边缘）在相对较短的时间内获得切缘状态，将降低复发率。本研究的目的是比较在猪舌上不同技术获取高质量组织学玻璃切片的完整冷冻切片的效果。
我们比较了新鲜猪舌上冷冻切片玻璃的质量。部分舌切除术使用锐器（手术刀和剪刀）、电切模式下的电烙术或电烙术的凝血模式进行。对于这三种方法中的每一种，我们还比较了在切除线和 1 至 1.3 毫米厚处获得的冷冻切片，使用冷冻阶段的冷冻切片机或异戊烷。一位病理学家独立评估组织学玻璃切片上存在的上皮和肌肉的百分比和质量。
所有技术（28-38 分钟）都能在相对较短的时间内获得高质量的完整冷冻边缘。锐器解剖显示出更好的结果：标本的处理时间更短，组织学玻璃切片的质量更好。使用冷冻切片机或异戊烷进行冷冻阶段没有显示出任何显著差异。
高质量的完整冷冻边缘（Mohs 边缘）是可行的。使用锐器解剖技术可获得非常高质量的组织学玻璃切片。对于冷冻期，异戊烷和冷冻切片机都提供了非常好的结果。这种方法适用于动物，需要在临床情况下进一步研究。下一篇文章将介绍人类的经验：口腔舌癌的完整冷冻切片边缘（有可测量的 1 或 5 毫米厚的游离边缘）（临床经验第 2 部分 [CSO2008]）。
