Reiner G, Reiner A, Jakesz R, Kolb R
Onkologie. 1987 Apr;10(2):72-8. doi: 10.1159/000216376.
In a prospective, randomized trial in breast-cancer patients, the surgical procedure and the adjuvant regimen were determined intraoperatively, depending on the axillary lymph node involvement. Therefore, it was necessary to perform frozen section examinations on axillary lymph nodes. In this context it was important to analyze the value of the frozen section technique of lymph nodes in predicting axillary node involvement. In 162 patients with primary breast cancer we compared the results of the frozen sections and the paraffin histology. In 96% the intraoperative diagnosis was correct and in 4% (7 cases) the results were wrong. In 6 cases we observed a sampling error and in one case a small metastasis was misinterpreted as sinus histiocytosis. In these 7 cases less than 4 lymph nodes were examined in frozen sections and the total axillary node involvement was small (less than 4 involved nodes). There was no false positive report in this series. We conclude that frozen section examinations of axillary lymph nodes are suitable for intraoperative lymph node assessment, if at least 4 of the macroscopically most suspicious lymph nodes are observed. The final histological axillary staging (number of involved lymph nodes) has to be performed on paraffin-embedded material.
在一项针对乳腺癌患者的前瞻性随机试验中，手术程序和辅助治疗方案在术中根据腋窝淋巴结受累情况确定。因此，有必要对腋窝淋巴结进行冰冻切片检查。在这种情况下，分析淋巴结冰冻切片技术在预测腋窝淋巴结受累方面的价值很重要。我们对162例原发性乳腺癌患者的冰冻切片结果和石蜡组织学结果进行了比较。术中诊断正确率为96%，4%（7例）结果错误。其中6例存在抽样误差，1例小转移灶被误诊为窦性组织细胞增生症。在这7例中，冰冻切片检查的淋巴结少于4个，腋窝淋巴结受累总数较少（受累淋巴结少于4个）。本系列中无假阳性报告。我们得出结论，如果观察到至少4个宏观上最可疑的淋巴结，腋窝淋巴结冰冻切片检查适用于术中淋巴结评估。腋窝最终组织学分期（受累淋巴结数量）必须在石蜡包埋材料上进行。
