冷冻组织不同贴片方法对乳腺癌前哨淋巴结活检诊断的影响  

Effects of different patch methods of frozen tissue on the diagnosis of sentinel lymph nodes biopsy in breast cancer

作　　者：刘菲菲[1] 李雪[1] LIU Fei-fei;LI Xue(Department of Pathology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院病理科,北京100020

出　　处：《诊断病理学杂志》2023年第1期6-9,13,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨不同冷冻组织贴片方法对乳腺癌前哨淋巴结术中诊断的影响。方法回顾性分析2020-09—2022-03首都医科大学附属北京朝阳医院术中送检T1~2期原发性乳腺癌77例,前哨淋巴结258枚,共473块组织块,采用双面同贴、分贴,单面双片贴、四片贴方法制片,以前哨淋巴结石蜡切片及免疫组织化学细胞角蛋白染色切片为金标准,双盲法评分。结果切片质量评分单面双片贴最高(15.83分),双面分贴最低(13.70分),双面分贴用时最短但返工最多(317.37 s,25张),单面四片贴返工最少用时最长(358.15 s,5张),既用时短又返工少为单面双片贴(324.73 s,7张)。258枚SLN石蜡诊断转移阳性43枚,阴性215枚,诊断符合率单面四片贴、双片贴均较高(97%、96%),双面分贴最低(87%)。结论单面双片贴切片质量较高,制片速度较快且返工率低,与石蜡切片诊断结果符合率高,是术中诊断早期乳腺癌SLN转移的一种较为可靠的制片方法。Objective To explore the influence of different frozen tissue patch method on the intraoperative diagnosis of sentinel lymph nodes in breast cancer.Methods A total of 77 patients with T1-2 primary breast cancer and 258 sentinel lymph nodes(473 tissue blocks)from September 2020 to March 2022 were analyzed retrospectively in Beijing Chaoyang Hospital,Capital Meldical University.Four methods of double-sided pasting,double-sided separate pasting,single-sided double-patch pasting,and single-sided four-patch pasting were used to make slices.Paraffin sections of anterior sentinel lymph nodes and immunohistochemical cytokeratin staining were used as the gold standard,and scored by double-blind method.Results The slice quality score of single-sided double-patch method was the highest(15.83),the double-sided split-patch method was the lowest(13.70);however,it took the shortest time and had the most reworkable pieces.(317.37 s,25 pieces);the minimum number of reworked sheets was single-sided four pieces pasting method and it took the longest time(358.15 s,5 pieces),the short time and few reworked pieces were single-sided double-patch method(324.73 s,7 pieces).Of the 258 SLNs,43 were positive for metastasis and 215 were negative.The diagnostic coincidence rate of single-sided four-patch method and single-sided double-patch method were higher(97%,96%),and the double-sided patch method was the lowest(87%).Conclusion Single-sided double-patch method has higher quality,faster production speed and low rework rate,and has a high coincidence rate with the diagnosis result of paraffin section.It can be used as a reliable method for intraoperative diagnosis of SLN metastasis of early breast cancer.

关 键 词：乳腺癌 前哨淋巴结 冷冻制片 

分 类 号：R446.8[医药卫生—诊断学]