Gerber Stefan, Gengler Carole, Grätz Klaus W, Kruse Astrid L
Department of Craniomaxillofacial and Oral Surgery, University Hospital Zurich, Switzerland.
Head Neck Oncol. 2011 Dec 30;3:56. doi: 10.1186/1758-3284-3-56.
Taking intraoperative frozen sections (FS) is a widely used procedure in oncologic surgery. However so far no evidence of an association of FS analysis and premalignant changes in the surgical margin exists. Therefore, the aim of this study was to evaluate the impact of FS on different categories of the final margins of squamous cell carcinoma (SCC) of the oral cavity and lips.
FS, pT-stage, grading, and tumor localization of 178 patients with SCC of the oral cavity and lips were compared by uni- and multivariate analysis in patients with positive, dysplastic and negative surgical margin status.
Performed on 111 patients (62.4%), intraoperative FS did not have any statistically significant influence on final margin status, independent of whether it was positive (p = 0.40), dysplastic (p = 0.70), or negative (p = 0.70). Positive surgical margins in permanent sections were significantly associated with pT4-tumors (OR 5.61, p = 0.001). The chance for negative margins in permanent sections was significantly higher in tumors located in the tongue (OR 4.70, p = 0.01).
Our data suggests that intraoperative FS in SCC can be useful in selected cases. However it is not advisable as a routine approach.
术中取冰冻切片（FS）是肿瘤外科手术中广泛应用的操作。然而，目前尚无证据表明FS分析与手术切缘的癌前病变有关。因此，本研究的目的是评估FS对口腔和唇部鳞状细胞癌（SCC）不同类型最终切缘的影响。
对178例口腔和唇部SCC患者的FS、pT分期、分级和肿瘤定位进行单因素和多因素分析，比较手术切缘状态为阳性、发育异常和阴性的患者。
111例患者（62.4%）进行了术中FS，无论最终切缘是阳性（p = 0.40）、发育异常（p = 0.70）还是阴性（p = 0.70），术中FS对最终切缘状态均无统计学显著影响。永久切片中的阳性手术切缘与pT4期肿瘤显著相关（OR 5.61，p = 0.001）。位于舌部的肿瘤在永久切片中切缘阴性的几率显著更高（OR 4.70，p = 0.01）。
我们的数据表明，SCC术中FS在某些特定病例中可能有用。然而，不建议将其作为常规方法。
