Hyland C, Kheir S M, Kashlan M B
Am J Surg Pathol. 1981 Mar;5(2):179-91. doi: 10.1097/00000478-198103000-00007.
Useful morphologic criteria for frozen section diagnosis of pancreatic and periampullary carcinoma were established by prospective review of 64 frozen sections in this region, with permanent section correlation and patient follow-up. These were divided into three major and five minor criteria based on frequency of occurrence and reproducibility. Major criteria were: 1) nuclear size variation of 4:1 or greater between ductal epithelial cells, 2) incomplete ductal lumens, and 3) disorganized duct distribution. Minor criteria, less frequently and reproducibly observed but valuable diagnostic aids, included: 1) huge, irregular epithelial nucleoli; 2) necrotic glandular debris; 3) glandular mitoses; 4) glands unaccompanied by connective tissue stroma within smooth muscle bundles (periampullary biopsies); and 5) perineural invasion. Combined application of both major and minor criteria is especially helpful in cases complicated by chronic pancreatitis.
通过对该区域64例冰冻切片进行前瞻性回顾，并与永久切片对照及对患者进行随访，确立了用于胰腺和壶腹周围癌冰冻切片诊断的有用形态学标准。根据出现频率和可重复性，这些标准分为三大标准和五大次要标准。主要标准为：1）导管上皮细胞核大小差异达4倍或更大；2）导管管腔不完整；3）导管分布紊乱。次要标准虽观察到的频率较低且可重复性较差，但为有价值的诊断辅助依据，包括：1）巨大、不规则的上皮核仁；2）坏死的腺性碎片；3）腺性有丝分裂；4）平滑肌束内无结缔组织间质伴随的腺体（壶腹周围活检）；5）神经周围浸润。在合并慢性胰腺炎的病例中，联合应用主要和次要标准尤其有用。
