Trippel Mafalda, Slotta-Huspenina Julia, Becker Karen, Rau Tilman, Paepke Stefan, Maurer-Marti Franziska, Langer Rupert
1 University of Bern, Bern, Switzerland.
2 Technische Universität München, München, Germany.
Int J Surg Pathol. 2018 Dec;26(8):693-700. doi: 10.1177/1066896918780346. Epub 2018 Jun 28.
The evaluation of the trimming surfaces (TS) of tissue blocks from frozen sections may serve as a supplementary examination tool for the intraoperative determination of resection margins of breast cancer specimens. This study aimed at the investigation of the feasibility and reliability of this technique, which has been described only very rarely in literature.
Two observers assessed digital images from TS obtained from 57 resection margins. Findings were correlated with the diagnosis of the frozen section (FS) alone and the final diagnosis on formalin-fixed paraffin-embedded (FFPE) material.
The determination of the resection margin on TS was estimated as feasible for all cases. Interobserver congruence rate for TS was 96% (κ = 0.81), which was lower compared with FFPE (100%, κ = 1.0) but superior to FS (89%, κ = 0.67). Intraobserver congruence of the 2 reviewers was 96.5% and 93.0% between TS and FFPE, and 91.1% and 92.5% between FS and FFPE, respectively. The combination of both intraoperative consultation techniques showed similar congruence but a slight improvement for the sensitivity (0.75 to 0.875) for the diagnosis of tumor at the resection margin in FFPE for Reviewer 1 but was unchanged for Reviewer 2.
The additional evaluation of TS can be a helpful additional tool for intraoperative margin assessment of breast cancer specimens, in particular, when processing artifacts of FS are encountered.
对冰冻切片组织块的修整面（TS）进行评估，可作为术中确定乳腺癌标本切除边缘的辅助检查工具。本研究旨在探讨该技术的可行性和可靠性，该技术在文献中仅有极少描述。
两名观察者评估了从57个切除边缘获取的TS的数字图像。将结果与单独的冰冻切片（FS）诊断以及福尔马林固定石蜡包埋（FFPE）材料的最终诊断进行关联。
估计对所有病例而言，在TS上确定切除边缘都是可行的。TS的观察者间一致性率为96%（κ = 0.81），与FFPE（100%，κ = 1.0）相比更低，但优于FS（89%，κ = 0.67）。两位观察者在TS和FFPE之间的观察者内一致性分别为96.5%和93.0%，在FS和FFPE之间分别为91.1%和92.5%。两种术中会诊技术联合使用显示出相似的一致性，但对于观察者1，在FFPE中诊断切除边缘肿瘤的敏感性略有提高（从0.75提高到0.875），而对于观察者2则无变化。
对TS进行额外评估可成为乳腺癌标本术中边缘评估的有用辅助工具，特别是在遇到FS的处理伪像时。
