Veenstra Marleen, Ostertag Judith, Verhaegh Marc, Nuessle Nils, Moehrle Matthias
*Mohs Klinieken Eindhoven, Eindhoven, the Netherlands; †Universitäts-Hautklinik Tübingen, Tübingen, Germany; ‡Praxisklinik Tübingen-Haut und Venen, Dr. A. Bern und Prof. Dr. M. Möhrle, Tübingen, Germany.
Dermatol Surg. 2016 May;42(5):665-71. doi: 10.1097/DSS.0000000000000708.
Although most cases of basal cell carcinoma (BCC) are curable, facial and recurrent BCCs require time consuming and labor-intensive Mohs micrographic surgery (MMS) to ensure complete removal with optimal cosmetic results. To handle the skin cancer epidemic, there is an urgent need to speedup MMS. Recently, rapid lump examination (RLE) has been shown to enable quick histologic examination, but its usefulness within MMS is unknown.
To evaluate the accuracy of RLE for the detection of residual BCC during MMS.
Twenty-two BCCs of various subtypes were evaluated by means of RLE and standard fresh frozen section (FFS) examination. For RLE, the freshly excised tissue was stained with toluidine blue and imaged with a stereomicroscope before being subdivided into sections suitable for processing into FFS. Fresh frozen sections were stained with hemotoxylin and eosin and evaluated with light microscopy.
Using FFS examination as the gold standard for the detection of residual BCC, RLE had a sensitivity, specificity, positive predictive value, and negative predictive value of 83.8%, 94.0%, 83.8%, and 94.0%, respectively.
As RLE enables quick 3-dimensional visualization of surgical margins for the detection of residual BCC, it holds the potential to speedup histologic examination during MMS.
尽管大多数基底细胞癌（BCC）病例是可治愈的，但面部和复发性基底细胞癌需要耗时且费力的莫氏显微外科手术（MMS）来确保完全切除并获得最佳美容效果。为应对皮肤癌流行问题，迫切需要加快莫氏显微外科手术的速度。最近，快速肿块检查（RLE）已被证明能够实现快速组织学检查，但其在莫氏显微外科手术中的实用性尚不清楚。
评估快速肿块检查（RLE）在莫氏显微外科手术（MMS）中检测残留基底细胞癌（BCC）的准确性。
通过快速肿块检查（RLE）和标准新鲜冷冻切片（FFS）检查对22例不同亚型的基底细胞癌进行评估。对于快速肿块检查（RLE），将新鲜切除的组织用甲苯胺蓝染色，并用体视显微镜成像，然后再分成适合处理成新鲜冷冻切片的部分。新鲜冷冻切片用苏木精和伊红染色，并用光学显微镜进行评估。
以新鲜冷冻切片检查作为检测残留基底细胞癌的金标准，快速肿块检查（RLE）的灵敏度、特异度、阳性预测值和阴性预测值分别为83.8%、94.0%、83.8%和94.0%。
由于快速肿块检查（RLE）能够快速对手术切缘进行三维可视化以检测残留基底细胞癌，它有潜力加快莫氏显微外科手术期间的组织学检查速度。
