Rapid Lump Examination (RLE) - a new tool for Mohs surgery?
Rapid Lump Examination (RLE) - a new tool for Mohs surgery?
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DOI：
10.1111/j.1610-0387.2011.07692.x
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发表时间：
2011-07-01
影响因子：
3.6
通讯作者：
Metzler, Gisela
中科院分区：
文献类型：
--
作者：
Moehrle, Matthias;Kaeflein, Leila;Metzler, Gisela
背景：“显微外科”保留了组织，导致较少的复发。已经描述了使用来自体外共聚焦激光扫描显微镜的石蜡包埋和冷冻切片，甚至光学切片的各种技术。本文介绍的技术是对标本(肿块)表面进行快速直接显微镜检查(RLE)。方法：新鲜手术组织先不经切片染色，然后在显微镜下直接检查。建立了95秒的基底细胞癌(BCC)染色方法。129例标本用数字显微镜检查，78例标本用体视显微镜检查。结果：与石蜡包埋H&E染色切片相比，RLE具有较高的诊断准确率。RLE的灵敏度和特异度分别为91%和90%，体视显微镜为90%和94%。此外，我们还建立了一种使用BerEp4抗体的7min RLE免疫组织学方法。在这里，这项技术已经为基底细胞癌建立了，但这一原理也可能转移到其他肿瘤的组织床边诊断上。这项技术不会改变或破坏组织，因此在RLE完成后，后续的传统组织学仍然是可能的。在显微外科手术中，RLE可能是一种省时、省钱的诊断方法。
Background: "Micrographic surgery" spares tissue and results in fewer recurrences. Various techniques have been described using paraffin-embedded and cryostat sections or even optical sections from ex vivo confocal laser scanning microscopy. The presented technique is the rapid direct microscopy of the surface of a specimen ( lump) for a pathological examination (RLE).Methods: Fresh surgical tissue was stained first without sectioning and then was examined directly under microscope. A 95 sec staining protocol for basal cell carcinoma (BCC) was established. 129 specimens were examined using a digital microscope and 78 specimens using a stereo microscope.Results: RLE had a high diagnostic accuracy compared to paraffin-embedded H&E-stained sections. Sensitivity and specificity of RLE was 91 % and 90 % for the digital and 90 % and 94 % for the stereo microscope. In addition we developed a 7 min RLE-immunohistology protocol using the BerEp4-antibody.Discussion: RLE is a simple and accurate technique for fresh tissue examination. Here, the technique has been established for BCC but the principle may also be transferred to histological bedside diagnosis of other tumors. The technique does not alter or destroy tissue, so that after RLE was done subsequent conventional histology is still possible. RLE might yield a time- and cost-saving diagnosis in micrographic surgery.