Sroa Novie, Campbell Shannon, Ravitskiy Larisa
The Division of Dermatology, The Ohio State University Medical Center, Columbus, Ohio.
J Clin Aesthet Dermatol. 2009 Jul;2(7):37-42.
Mohs micrographic surgery has become the "gold standard" for surgical excision of nonmelanoma skin cancers for maximal preservation of normal tissue. Mohs micrographic surgery entails processing specimens in horizontal frozen sections with immediate examination under a light microscope. This technique offers the examination of lateral and deep margins in the same plane in contrast to wide local excision. Success with Mohs micrographic surgery depends on accurate mapping of the tumor, correct interpretation of the histopathological sections, and appreciation of aggressive tumor characteristics. The most common reason for recurrence of tumor after Mohs micrographic surgery is residual undetected tumor. Because hematoxylin and eosin stains may present difficulties in interpretation, immunohistochemistry techniques are being used to supplement these routine stains. Although immunohistochemistry is not being widely utilized by Mohs micrographic surgery surgeons, the many advantages of immunohistochemistry over routine staining of frozen sections in selected settings is of great value. Herein, the authors review the application of immunohistochemistry in Mohs micrographic surgery for a variety of neoplasms encountered most frequently by Mohs micrographic surgery surgeons. (J Clin Aesthetic Dermatol. 2009;2(7):37-42.).
莫氏显微外科手术已成为非黑色素瘤皮肤癌手术切除的“金标准”，可最大程度地保留正常组织。莫氏显微外科手术需要对水平冰冻切片进行标本处理，并在光学显微镜下立即检查。与广泛局部切除相比，该技术可在同一平面上检查肿瘤的外侧和深部边缘。莫氏显微外科手术的成功取决于肿瘤的精确绘图、组织病理学切片的正确解读以及对侵袭性肿瘤特征的认识。莫氏显微外科手术后肿瘤复发的最常见原因是残留未检测到的肿瘤。由于苏木精和伊红染色在解读上可能存在困难，免疫组织化学技术正被用于补充这些常规染色。尽管免疫组织化学尚未被莫氏显微外科手术医生广泛应用，但在特定情况下，免疫组织化学相对于冰冻切片常规染色的诸多优势具有重要价值。在此，作者回顾了免疫组织化学在莫氏显微外科手术中针对莫氏显微外科手术医生最常遇到的各种肿瘤的应用。（《临床美容皮肤病学杂志》。2009年；2(7):37 - 42。）
