Tamhane Ankita Narendra, Shukla Samarth, Acharya Sourya, Acharya Neema, Hiwale Kishor, Bhake Arvind
Department of Pathology, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India.
Int J Appl Basic Med Res. 2020 Jan-Mar;10(1):12-16. doi: 10.4103/ijabmr.IJABMR_325_18. Epub 2020 Jan 3.
Touch imprint cytology (TIC) and frozen section diagnosis are valuable intraoperative guides for the management of malignancies as they make a prompt therapeutic decision that may prevent surgical re-intervention. The present study emphasizes on the correlation of TIC and frozen section for the evaluation of surgical margins considering histopathological diagnosis as the gold standard.
The aim of the study was to assess the accuracy of frozen section diagnosis and TIC in the evaluation of surgical margin clearance.
It is a prospective analytical study of 103 patients carried in the histopathology section of department of pathology for 1 year from July 2017 to July 2018. Specimens were received in the frozen section room, grossed by the standard protocol. Touch imprints of margins were taken, and frozen sections were stained by rapid hematoxylin and eosin stain. The same margins were sent for permanent histopathology sections.
Of 103 patients, 51 (49.51%) were oral squamous cell carcinoma, 35 (33.98%) carcinoma breast, 9 (8.74%) carcinoma colon, 4 (3.88%) squamous cell carcinoma of skin, 3 (2.91%) basal cell carcinoma, and 1 (0.97%) malignant peripheral nerve sheath tumor. Frozen section diagnosis for margin clearance of the above organs showed that the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were found to be 100%, 98.71%, 100%, 100%, and 99.02%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of TIC for surgical margin clearance were 46.15%, 100%, 100%, 84.62%, and 86.40%, respectively.
Frozen section diagnosis is an accurate method for the assessment of surgical margin clearance as compared to TIC. This study evaluated predominantly epithelial malignancies than mesenchymal malignancies, thus emphasizing its utility in it. More research needs to be done for the assessment of the utility of these lesions.
触摸印片细胞学检查（TIC）和冰冻切片诊断是恶性肿瘤治疗中很有价值的术中指导方法，因为它们能迅速做出治疗决策，从而避免再次手术干预。本研究以组织病理学诊断为金标准，着重探讨TIC与冰冻切片在评估手术切缘方面的相关性。
本研究旨在评估冰冻切片诊断和TIC在评估手术切缘清除情况方面的准确性。
这是一项前瞻性分析研究，于2017年7月至2018年7月在病理科组织病理学组对103例患者进行了为期1年的研究。标本送至冰冻切片室，按标准流程进行大体检查。取切缘的触摸印片，冰冻切片用快速苏木精和伊红染色。相同的切缘送去做常规组织病理学切片。
103例患者中，51例（49.51%）为口腔鳞状细胞癌，35例（33.98%）为乳腺癌，9例（8.74%）为结肠癌，4例（3.88%）为皮肤鳞状细胞癌，3例（2.91%）为基底细胞癌，1例（0.97%）为恶性外周神经鞘瘤。上述器官切缘清除情况的冰冻切片诊断显示，其敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性分别为100%、98.71%、100%、100%和99.02%。TIC评估手术切缘清除情况的敏感性、特异性、PPV、NPV和准确性分别为46.15%、100%、100%、84.62%和86.40%。
与TIC相比，冰冻切片诊断是评估手术切缘清除情况的准确方法。本研究主要评估的是上皮性恶性肿瘤而非间叶性恶性肿瘤，从而强调了其在这方面的实用性。对于评估这些病变的实用性，还需要进行更多研究。
