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[头颈部肿瘤的术中冰冻切片诊断:日常实践中的可能性、局限性、陷阱与技巧]

[Intraoperative frozen section diagnosis of head and neck tumors: possibilities, limitations, pitfalls and tips for the daily practice].

作者信息

Agaimy A, Stelzle F, Zenk J, Iro H

机构信息

Pathologisches Institut, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstr. 8-10, 91054, Erlangen, Deutschland.

出版信息

Pathologe. 2012 Sep;33(5):389-96. doi: 10.1007/s00292-012-1598-4.

Abstract

Intraoperative consultation (synonym: frozen section diagnostics) has increasingly gained significance for the daily practice in head and neck surgery. The main aim of this investigation method which is usually associated with much stress and effort is to facilitate an optimal and timely oncological surgical treatment of neoplastic diseases with a minimum rate of postoperative functional disturbance. In order to achieve this purpose pathologists are expected to deliver as much correct information as possible to accurately influence intraoperative surgical decisions. At the same time this aim should be reached without significantly and unnecessarily increasing the workload for the pathology laboratory and without significantly inducing tissue artifacts. This would otherwise negatively influence the tissue quality for permanent section examination and consequently the overall quality of diagnosis and tumor staging. Thus, the quality and efficacy of frozen sections span a spectrum with the highest quality having the least possible false negative rate on the one hand and a false positive result of approximately zero on the other hand. Sticking to this approach would result in a high positive impact on the surgical treatment of a variety of neoplastic diseases and help to minimize or even eliminate the rate of medicolegal consequences.

摘要

术中会诊(同义词:冰冻切片诊断)在头颈外科的日常实践中越来越重要。这种通常伴随着很大压力和工作量的检查方法的主要目的是促进对肿瘤性疾病进行最佳、及时的肿瘤外科治疗,同时使术后功能障碍发生率降至最低。为了实现这一目的,期望病理学家提供尽可能多的正确信息,以准确影响术中手术决策。与此同时,应在不显著且不必要地增加病理实验室工作量以及不显著导致组织假象的情况下实现这一目标。否则,这会对用于永久切片检查的组织质量产生负面影响,进而影响诊断和肿瘤分期的整体质量。因此,冰冻切片的质量和效能涵盖一个范围,一方面最高质量意味着尽可能低的假阴性率,另一方面假阳性结果接近零。坚持这种方法将对各种肿瘤性疾病的外科治疗产生积极影响,并有助于将医疗法律后果的发生率降至最低甚至消除。

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