Department of Oral and Plastic Maxillofacial Surgery, Central German Armed Forces Hospital, Rübenacher Str. 170, D-56072 Koblenz.
Head Neck. 2010 Nov;32(11):1473-8. doi: 10.1002/hed.21350.
The aim of this study was to examine the use of trephine drill specimens from mandible bony margins subjected to standard histologic fresh-frozen processing for intraoperative documentation of malignant bony infiltration in oral cancer.
Eighty-four drill specimens were extracted from bony mandibular resection margins of 20 patients with oral cancer. Histologic results of decalcification and of intraoperative frozen-section analysis were compared.
Sixty-eight (81%) of 84 specimens showed no tumor infiltration, whereas 16 (19%) were positive in frozen section analysis. Four specimens (4.8%) were evaluated as free of tumor invasion, but showed erosion of the bone by the tumor after decalcification. One specimen (2.4%) was positive, but no invasion could be found with standard decalcification. Overall, there was 94% (79) consistency between the 2 techniques, with a sensitivity of 79% and specificity of 98%.
This technique promises to be suitable for intraoperative detection of malignant bone infiltration.
本研究旨在探讨在颌骨骨缘用环钻钻取标本，进行标准组织学新鲜冷冻处理，以记录口腔癌术中恶性骨浸润的情况。
从 20 例口腔癌患者的颌骨骨缘中提取 84 个环钻标本。比较脱钙和术中冷冻切片分析的组织学结果。
84 个标本中 68 个（81%）无肿瘤浸润，而 16 个（19%）在冷冻切片分析中呈阳性。4 个标本（4.8%）被评估为无肿瘤侵犯，但脱钙后显示肿瘤侵蚀骨。1 个标本（2.4%）为阳性，但用标准脱钙法未发现侵犯。总的来说，两种技术之间有 94%（79 个）的一致性，敏感性为 79%，特异性为 98%。
该技术有望适用于术中检测恶性骨浸润。
