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[福尔马林固定后舌标本手术切缘收缩情况的评估]

[Evaluation of shrinkage of surgical margins on tongue specimens following formalin fixation].

作者信息

Gökoğlu Özgür, Polat Kerem, Aydın Erdinç, Uysal Ismail Önder, Doğan Mansur, Özen Ozlem Işıksaçan

机构信息

Department of Otolaryngology, Akşehir State Hospital, 42550 Akşehir, Konya, Turkey.

出版信息

Kulak Burun Bogaz Ihtis Derg. 2014 Jan-Feb;24(1):30-7. doi: 10.5606/kbbihtisas.2014.73554.

Abstract

OBJECTIVES

This study aims to evaluate the alterations in distances to the surgical margins on sheep tongue specimens, through resection, formalin fixation, frozen section, and microscopic examination.

MATERIALS AND METHODS

Fifty fresh sheep tongues were used in the study. A metal plate was fixed on the lateral aspect of each tongue to represent tumor tissues. A total of 40 specimens with either 1 cm or 2 cm distances as surgical safety margins of the surrounding plate were prepared using either scalpel or monopolar cautery (10 specimens were prepared for each group). Additional 10 specimens with 1 cm safety margins were prepared using either scalpel or monopolar cautery (5 specimens per group) for frozen section examination. Distances to the metal plates before resection were compared with the ones which were determined after resection, frozen section examination, 24-hour formalin fixation and microscopic examination.

RESULTS

Distances to the surgical margins were found to be decreased in all specimens after resection, 10% formalin fixation and microscopic examination. The distances to the surgical margins were observed to be reduced by 6.5-7.5% on average after resection, 10-12% on average after formalin fixation and 30% on average after microscopic examination, compared to the baseline values. The level of shrinkage was reduced by 6.3-10% following microscopic section preparation during frozen section examination.

CONCLUSION

Seven to eight-millimeter distance to the surgical margin at minimum should be maintained to achieve a 5 mm in height surgical safety margin during sheep tongue resection. The distance defined by the pathologist may be multiplied with 1.42 to estimate around in-situ distance to the surgical margins. Therefore, 1.42 may be used as a corrective factor for sheep tongue tissues.

摘要

目的

本研究旨在通过切除、福尔马林固定、冰冻切片和显微镜检查,评估绵羊舌标本手术切缘距离的变化。

材料与方法

本研究使用了50个新鲜绵羊舌。在每个舌的侧面固定一块金属板以代表肿瘤组织。使用手术刀或单极电灼法制备了总共40个标本,其周围金属板的手术安全切缘距离为1厘米或2厘米(每组制备10个标本)。另外使用手术刀或单极电灼法制备了10个切缘距离为1厘米的标本(每组5个)用于冰冻切片检查。将切除前到金属板的距离与切除后、冰冻切片检查、24小时福尔马林固定和显微镜检查后确定的距离进行比较。

结果

在切除、10%福尔马林固定和显微镜检查后,所有标本的手术切缘距离均减小。与基线值相比,切除后手术切缘距离平均减少6.5 - 7.5%,福尔马林固定后平均减少10 - 12%,显微镜检查后平均减少30%。在冰冻切片检查过程中,显微镜切片制备后收缩水平降低了6.3 - 10%。

结论

在绵羊舌切除术中,为了获得5毫米高的手术安全切缘,至少应保持7至8毫米的手术切缘距离。病理学家确定的距离可乘以1.42来估计手术切缘周围的原位距离。因此,1.42可作为绵羊舌组织的校正因子。

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