Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Entrerríos s/n 15782, Santiago de Compostela, A Coruña, Spain,
Lasers Med Sci. 2013 Nov;28(6):1591-7. doi: 10.1007/s10103-013-1266-9. Epub 2013 Jan 17.
Laser use for biopsy of suspicious lesions may simulate cytological atypia at the margin of the incisions, challenging pathological diagnosis. Erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser has shown promising results in experimental models by inducing fewer artifacts. The aims of this study were to examine the thermal wounds induced by Er,Cr:YSGG laser in a short series of oral leukoplakias in terms of cytological and epithelial architectural changes and also to assess the width of the thermal damage lateral to the incision. Four oral leukoplakia patients entered the study and underwent complete surgical excision of their lesions by using Er,Cr:YSGG laser. Patients were weekly controlled until complete healing was accomplished. The patients were included on the existing follow-up program for these lesions thereafter. Study samples were routinely processed by the same technician and double-blindedly studied by two pathologists until a consensus was reached for each case. The pathological analysis of the samples revealed no autolysis and no fixation- or handling-related artifacts. However, cellular and nuclear polymorphism could be observed in two samples. Loss of intercellular adherence was the most frequent thermal artifact in this series; all pseudodysplastic artifacts recognized in the study were of low intensity and located at the basal and suprabasal layers of the leukoplakias' epithelium. The width of the thermal damage at the edge of the incision scored an average of 26.60 ± 25.3 μm. It is concluded that irradiation with Er,Cr:YSGG laser induces a minimal amount of thermal artifacts at the surgical margins of oral leukoplakias and avoids diagnostic interferences with real dysplastic borders.
激光用于可疑病变的活检可能会在切口边缘模拟细胞学异型性，从而对病理诊断构成挑战。铒铬：钇钪石榴石（Er,Cr:YSGG）激光在实验模型中已显示出良好的效果，因为它产生的伪影较少。本研究的目的是检查 Er,Cr:YSGG 激光在一组短时间的口腔白斑病变中诱导的热损伤，根据细胞学和上皮结构变化进行评估，并评估切口边缘侧向的热损伤宽度。四名口腔白斑病患者进入研究，通过使用 Er,Cr:YSGG 激光对其病变进行完全手术切除。患者每周接受一次控制，直到完全愈合。此后，患者被纳入这些病变的现有随访计划。研究样本由同一位技术人员常规处理，并由两位病理学家进行双盲研究，直到每个病例达成共识。样本的病理分析显示没有自溶，也没有固定或处理相关的伪影。然而，在两个样本中可以观察到细胞和核的多态性。细胞间黏附丧失是该系列中最常见的热损伤伪影；研究中识别的所有假异型性伪影强度均较低，位于白斑上皮的基底和超基底层。切口边缘热损伤的宽度平均为 26.60±25.3μm。结论是，Er,Cr:YSGG 激光的照射在口腔白斑的手术边缘仅引起少量的热损伤伪影，并且不会与真实的异型性边界产生诊断干扰。
