Yadav Gatha Singh, Donoghue Mandana, Tauro David P, Bharani Siva, Kumar Mohan, Yadav Ashutosh
Department of Oral Pathology and Microbiology, Kothiwal Dental College and Research Centre, Moradabad, India.
Acta Cytol. 2014;58(1):53-9. doi: 10.1159/000355289. Epub 2013 Nov 15.
Eradication of malignant tumors at the primary site with oncological safe margin is a critical requirement for obtaining better survival rate and less recurrence. Touch imprint cytology (TIC) has proven itself as a quick, simple, inexpensive, highly accurate and reliable intraoperative technique to assess surgical margins in squamous cell carcinomas of the oral cavity. However, it is still unclear how the mode of excision, i.e. by scalpel (SC) and electrocautery (EC), or the method of staining, i.e. Papanicolaou (PAP) and cytohaem, affect the diagnostic accuracy of TIC.
To study the influence of confounding factors like mode of excision (EC/SC) and staining (PAP/cytohaem) on the diagnostic accuracy of intraoperative TIC technique for assessing surgical margins in oral squamous cell carcinoma in comparison to paraffin-embedded HE-stained sections.
Thirty patients underwent surgical treatment for primary oral squamous cell carcinoma. Three hundred and forty-eight touch imprint slides were prepared from 174 margins of 30 resected tumor specimens. Two adjacent tissues from the margin to be evaluated were imprinted to observe differences between surfaces excised by EC and SC. The set of imprint from each margin tissue was stained with PAP and cytohaem. The TIC results of 180 EC-excised margins and 168 SC-excised margins were compared. Results of 174 imprints stained with RAPID-PAP were compared to their counterpart comprising of 174 cytohaem-stained imprints. The slides were diagnosed as positive, negative or suspicious for tumor. Finally, TIC results were checked against their respective histopathological sections.
No statistically significant difference was found between the results of imprints from EC/SC-excised margins (Z = 0.44, p = 0.70) or the imprints stained with PAP/cytohaem (Z = 0.44, p = 0.70).
Confounding factors like mode of excision and staining procedure do not significantly influence the results of imprint cytology.
在肿瘤学安全切缘的情况下根除原发性恶性肿瘤是提高生存率和减少复发的关键要求。触摸印片细胞学检查（TIC）已被证明是一种快速、简单、廉价、高度准确且可靠的术中技术，可用于评估口腔鳞状细胞癌的手术切缘。然而，尚不清楚切除方式，即手术刀（SC）和电灼术（EC），或染色方法，即巴氏染色法（PAP）和血细胞染色法，如何影响TIC的诊断准确性。
与石蜡包埋苏木精-伊红（HE）染色切片相比，研究切除方式（EC/SC）和染色（PAP/血细胞染色法）等混杂因素对术中TIC技术评估口腔鳞状细胞癌手术切缘诊断准确性的影响。
30例原发性口腔鳞状细胞癌患者接受手术治疗。从30个切除的肿瘤标本的174个切缘制备了3百48张触摸印片玻片。从待评估切缘取两个相邻组织进行印片，以观察EC和SC切除表面之间的差异。每个切缘组织的印片组用PAP和血细胞染色法染色。比较180个EC切除切缘和168个SC切除切缘的TIC结果。将174个用快速巴氏染色法（RAPID-PAP）染色的印片结果与其对应的174个血细胞染色印片结果进行比较。玻片被诊断为肿瘤阳性（有癌细胞）、阴性（无癌细胞）或可疑。最后，将TIC结果与其各自的组织病理学切片进行对照检查。
EC/SC切除切缘的印片结果（Z = 0.44，p = 0.70）或PAP/血细胞染色法染色的印片结果（Z = 0.44，p = 0.70）之间未发现统计学上的显著差异。
切除方式和染色程序等混杂因素不会显著影响印片细胞学检查的结果。
