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头颈部外科病理学中的冰冻切片分析:术中病理咨询的过去、现在和未来的叙述性综述。

Frozen Section Analysis in Head and Neck Surgical Pathology: A Narrative Review of the Past, Present, and Future of Intraoperative Pathologic Consultation.

机构信息

THANC (Thyroid, Head & Neck Cancer) Foundation, New York, NY, USA; Dept. of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, NY, USA.

THANC (Thyroid, Head & Neck Cancer) Foundation, New York, NY, USA.

出版信息

Oral Oncol. 2023 Aug;143:106445. doi: 10.1016/j.oraloncology.2023.106445. Epub 2023 Jun 6.

Abstract

Frozen section has remained the diagnostic gold standard for intraoperative pathological evaluation of surgical margins for head and neck specimens. While achieving tumor-free margins is of utmost importance to all head and neck surgeons, in practice, there are numerous debates and a lack of standardization for the role and method of intraoperative pathologic consultation. This review serves as a summary guide to the historical and contemporary practice of frozen section analysis and margin mapping in head and neck cancer. In addition, this review discusses current challenges in head and neck surgical pathology, and introduces 3D scanning as a groundbreaking technology to bypass many of the pitfalls in the current frozen section workflow. The ultimate goal for all head and neck pathologists and surgeons should be to modernize practices and take advantage of new technology, such as virtual 3D specimen mapping techniques, that improves the workflow for intraoperative frozen section analysis.

摘要

冰冻切片一直是头颈部标本手术切缘术中病理评估的诊断金标准。虽然对所有头颈部外科医生来说,达到无肿瘤切缘至关重要,但在实践中,术中病理咨询的作用和方法存在许多争议且缺乏标准化。本综述旨在对头颈部癌症中冰冻切片分析和切缘绘图的历史和现代实践进行总结。此外,本综述还讨论了头颈部外科病理学当前面临的挑战,并介绍了 3D 扫描技术作为一种开创性技术,可以避免当前冰冻切片工作流程中的许多陷阱。所有头颈部病理学家和外科医生的最终目标都应该是使实践现代化,并利用新技术(如虚拟 3D 标本绘图技术),以改善术中冰冻切片分析的工作流程。

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