Bhaker Poonam, Mohan Harsh, Handa Uma, Kumar Sudhir
Department of Pathology, Research Block-A, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012, India.
Department of Pathology, Sarai Building, Government Medical College and Hospital, Sector-32, Chandigarh 160030, India.
Sarcoma. 2014;2014:902104. doi: 10.1155/2014/902104. Epub 2014 May 19.
Early and accurate detection of bone tumors and their staging are important since some of them are highly malignant. Intraoperative pathological consultation in bone tumors and tumor-like conditions is quite complex; however, it allows improvement in prognosis and limb salvage. Present study was conducted on 52 patients who underwent surgical procedure after clinical and radiological diagnosis of bone tumors/tumor-like conditions. Fresh unfixed tissue was quickly inspected grossly, followed by preparation of imprint smears and frozen section which were evaluated by two pathologists separately and compared subsequently with reports of paraffin-embedded sections. Clinical reasons for intraoperative consultation were to make diagnosis in 65.4% of cases and to determine resection margin status in 21.1% while in 13.5% of cases, it was for both indications. Diagnostic yield of imprint smears was 87.8% (13 malignant, 22 benign, and 1 tumor-like) and of frozen section was 90.2% (16 malignant, 19 benign, and 2 nonneoplastic) while paraffin sections could diagnose specific tumors in 95.1% (18 malignant, 18 benign, and 3 nonneoplastic). Although frozen section had better sensitivity (88.2%), it had less specificity (94.7%) as compared to imprint smears (76.5% and 100%, resp.). Imprint cytology and frozen section together provide a quick, safe, and reliable intraoperative provisional tissue diagnosis in skeletal tumors and tumor-like conditions.
由于某些骨肿瘤具有高度恶性，因此早期准确检测骨肿瘤及其分期非常重要。骨肿瘤和肿瘤样病变的术中病理会诊相当复杂；然而，它有助于改善预后和保肢。本研究对52例经临床和放射学诊断为骨肿瘤/肿瘤样病变后接受手术的患者进行。对新鲜未固定的组织进行快速大体检查，随后制备印片涂片和冰冻切片，由两位病理学家分别评估，随后与石蜡包埋切片的报告进行比较。术中会诊的临床原因在65.4%的病例中是为了做出诊断，在21.1%的病例中是为了确定切除边缘状态，而在13.5%的病例中，是为了这两个指征。印片涂片的诊断率为87.8%（13例恶性、22例良性和1例肿瘤样），冰冻切片的诊断率为90.2%（16例恶性、19例良性和2例非肿瘤性），而石蜡切片能在95.1%的病例中诊断出特定肿瘤（18例恶性、18例良性和3例非肿瘤性）。尽管冰冻切片具有更好的敏感性（88.2%），但与印片涂片相比，其特异性较低（分别为94.7%和76.5%、100%）。印片细胞学和冰冻切片共同为骨骼肿瘤和肿瘤样病变提供了快速、安全和可靠的术中临时组织诊断。
