Terry Jesse L, Milovancev Milan, Nemanic Sarah, Löhr Christiane V
Departments of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, Oregon.
Biomedical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, Oregon.
Vet Surg. 2017 Feb;46(2):189-196. doi: 10.1111/vsu.12602. Epub 2016 Dec 19.
To evaluate degree length change of lateral surgical margins at various stages of processing for histological examination and quantify the length change between grossly normal surgical margins (GNSM) and pathologist-reported histologic tumor-free margin (HTFM) in widely resected feline injection site sarcoma (FISS) specimens.
Prospective clinical study.
Five client-owned cats with injection site sarcomas.
All cats underwent wide surgical excision (35-55 mm gross lateral margins, 2 fascial planes deep). Gross normal lateral margin measurements from tumor edge were recorded in 4 directions (cranial, caudal, dorsal, ventral) at 5 time points: intra-op (in vivo GNSM); immediately following excision (ex vivo GNSM); following formalin fixation (post-fixation GNSM); after trimming and mounting on glass slides (on-slide GNSM); and HTFM at the narrowest point from the HTFM from the same slides used for on-slide GNSM. Percent change in lateral margin length from in vivo measurements was quantified at each time point and compared using 1-way repeated measures ANOVA.
The largest mean decrease in percent GNSM length occurred immediately after excision (in vivo to ex vivo GNSM = 29%; P = .016). Formalin fixation, trimming, and mounting on slides did not result in additional significant changes in length. Mean HTFM length was significantly decreased compared to both in vivo GNSM (33%; P = .014) and on-slide GNSM (7%; P = .024).
Significant decreases in surgical margin length in FISS specimens occur immediately following excision (prior to formalin fixation). Subgross evaluation of tumor-free margins from on-slide GNSM to HTFM overestimates the actual (histologic) tumor-free margins.
评估用于组织学检查的不同处理阶段外侧手术切缘的长度变化,并量化广泛切除的猫注射部位肉瘤(FISS)标本中大体正常手术切缘(GNSM)与病理学家报告的组织学无瘤切缘(HTFM)之间的长度变化。
前瞻性临床研究。
5只客户拥有的患有注射部位肉瘤的猫。
所有猫均接受广泛手术切除(外侧大体切缘35 - 55毫米,深达2个筋膜平面)。在5个时间点从肿瘤边缘记录大体正常外侧切缘在4个方向(头侧、尾侧、背侧、腹侧)的测量值:术中(体内GNSM);切除后立即(离体GNSM);福尔马林固定后(固定后GNSM);修剪并安装在载玻片上后(载玻片上GNSM);以及使用与载玻片上GNSM相同的载玻片在HTFM最窄点处的HTFM。在每个时间点量化外侧切缘长度相对于体内测量值的百分比变化,并使用单因素重复测量方差分析进行比较。
GNSM长度百分比的最大平均下降发生在切除后立即(体内到离体GNSM = 29%;P = 0.016)。福尔马林固定、修剪以及安装在载玻片上并未导致长度的额外显著变化。与体内GNSM(33%;P = 0.014)和载玻片上GNSM(7%;P = 0.024)相比,平均HTFM长度均显著降低。
FISS标本的手术切缘长度在切除后立即(福尔马林固定前)显著缩短。从载玻片上GNSM到HTFM对无瘤切缘的亚大体评估高估了实际(组织学)无瘤切缘。