Department of Obstetrics and Gynecology, Sapienza University, Rome, Italy.
Int J Gynaecol Obstet. 2011 Aug;114(2):120-3. doi: 10.1016/j.ijgo.2011.02.012. Epub 2011 Jun 12.
To assess the discrepancy between width of surgical margin measured with the naked eye/ruler by a surgeon before removing an invasive vulvar carcinoma, and width of margin measured under microscope by pathologist after fixation of the resected lesion with formalin. Potential relationships between discrepancy and disease recurrence were also investigated.
This prospective study was conducted with resected lesions from 86 women who underwent surgery for primary/recurrent invasive vulvar carcinoma. After the surgeon removed the lesions surrounded by 1-2-cm margins, the pathologist determined margin width at the 4 cardinal points of 86 lesions (for a total of 344 margin assessments), first macroscopically and then under the microscope.
A safety margin of 0.8 cm on microscopic view was achieved in 83% of cases (112 of 135) when the macroscopic measurement was 1cm, in 91% of cases (58 of 64) when it was 1.5 cm, and 98% of cases (105 of 107) when it was 2 cm.
There was a small discrepancy between the surgeon's intent and the microscopic margin measurement, mostly related to tissue shrinkage. A 1-cm surgical margin corresponded to a 0.8-cm margin in microscopic view (the "safe margin") in most cases.
评估外科医生在切除浸润性外阴癌前用肉眼/尺子测量的手术切缘宽度与病理医生在福尔马林固定切除病灶后用显微镜测量的切缘宽度之间的差异，并探讨这种差异与疾病复发之间的潜在关系。
本前瞻性研究纳入了 86 名接受原发性/复发性浸润性外阴癌手术的女性的切除病灶。外科医生切除了周围有 1-2cm 切缘的病灶后，病理医生在 86 个病灶的 4 个方位（共 344 个切缘评估）首先进行宏观测量，然后在显微镜下进行切缘宽度测量。
当宏观测量为 1cm 时，83%（112/135）的病例在显微镜下达到 0.8cm 的安全切缘，当宏观测量为 1.5cm 时，91%（58/64）的病例达到 0.8cm，当宏观测量为 2cm 时，98%（105/107）的病例达到 0.8cm。
外科医生的意图与显微镜下的切缘测量之间存在较小的差异，主要与组织收缩有关。在大多数情况下，1cm 的手术切缘在显微镜下对应 0.8cm 的切缘（“安全切缘”）。
