Shah Arpan K
Department of Oral Pathology and Microbiology, Manubhai Patel Dental College, Hospital and Oral Research Institute, Vadodara, Gujarat, India.
J Oral Maxillofac Pathol. 2018 Jan-Apr;22(1):78-85. doi: 10.4103/jomfp.JOMFP_185_16.
Adequacy of resection margins is of utmost importance for decisions regarding postoperative treatment and prediction of prognosis in patients with oral squamous cell carcinoma. However, there are differences in opinions about various basic concepts of surgical margins in oral and maxillofacial pathology. Fundamental issues such as concepts of positive or negative surgical margins and impact of epithelial dysplasia at margin require clarification to standardize the practice of postoperative margin surveillance. The issue of postresection tissue shrinkage must be considered and addressed while reporting the status of surgical margin. The current status of "molecular assessment" of resection margins is far from mature and it may expand the horizons of postoperative margin surveillance in future. The present review summarizes the fundamental concepts and methods involved in postoperative assessment of surgical margins in oral and maxillofacial pathology. This will help in understating the rationale of current approach for the assessment of resection margins. Understanding the limitations of the existing approach will also help to improve our practice of postoperative margin surveillance.
切缘是否足够对于口腔鳞状细胞癌患者术后治疗决策及预后预测至关重要。然而,在口腔颌面病理学中,关于手术切缘的各种基本概念存在不同观点。诸如手术切缘阳性或阴性的概念以及切缘上皮发育异常的影响等基本问题需要阐明,以规范术后切缘监测的实践。在报告手术切缘状态时,必须考虑并解决切除后组织收缩的问题。切缘“分子评估”的现状远未成熟,未来可能会拓展术后切缘监测的视野。本综述总结了口腔颌面病理学中术后手术切缘评估所涉及的基本概念和方法。这将有助于理解当前切缘评估方法的原理。了解现有方法的局限性也将有助于改进我们术后切缘监测的实践。