Stapler-lavage cytology using a new rapid immunocytochemistry for evaluating surgical margin status after pulmonary sublobar resection
Stapler-lavage cytology using a new rapid immunocytochemistry for evaluating surgical margin status after pulmonary sublobar resection
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使用新型快速免疫细胞化学进行吻合器灌洗细胞学评估肺亚肺叶切除术后切缘状态
DOI：
10.1007/s11748-021-01733-y
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发表时间：
2021
影响因子：
1.2
通讯作者：
Minamiya Yoshihiro
中科院分区：
文献类型：
--
作者：
Kurihara Nobuyasu;Imai Kazuhiro;Takashima Shinogu;Nanjo Hiroshi;Hiroshima Yuko;Ito Satoru;Nomura Kyoko;Saito Hajime;Minamiya Yoshihiro
目的肺小棒切除术被认为是选择肺转移或以某种方式受损患者的金标准。然而，叶下切除术后的一个不利结果是局部/边缘复发。本研究的目的是评估一种新的快速吻合器灌洗免疫细胞化学（ICC）技术评估切缘恶性肿瘤的临床可靠性。该方法使用非接触交流电（AC）混合来实现更稳定的染色。方法回顾性分析2016年9月至2017年12月间21例因肺转移或肺癌在受损宿主中行肺叶下切除术的患者，其中包括16例楔形切除术。术中对所有边缘标本进行冷冻切片HE染色和Papanicolaou染色和快速icc的吻合器灌洗细胞学评估。结果快速吻合器灌洗ICC在叶下切除术中可在20 min内诊断出手术安全边缘。尽管在所有病例中，根据冷冻切片的HE染色，边缘都被诊断为无癌，但根据快速ICC诊断为恶性阳性边缘的4例患者中，有2例经历了局部/边缘复发。结论AC混合快速吻合器灌洗ICC可作为快速判断肺叶下切除术后边缘恶性状态的临床工具。
ObjectiveSublobar resection is considered the gold standard for selected patients with pulmonary metastasis or who are compromised in some way. However, an unfavorable outcome after sublobar resection is local/margin recurrence. The aim of this study was to evaluate the clinical reliability of a new rapid-stapler lavage immunocytochemistry (ICC) technique for assessing margin malignancy. The method uses non-contact alternating current (AC) mixing to achieve more stable staining.MethodsTwenty-one patients who underwent sublobar resection, including 16 wedge resections, for pulmonary metastasis or lung cancer in a compromised host between September 2016 and December 2017 were retrospectively reviewed. All margin specimens were intraoperatively evaluated with HE staining of frozen sections and stapler lavage cytology using Papanicolaou staining and rapid-ICC.ResultsRapid-stapler lavage ICC can be used to diagnose surgically safe margins within 20 min during sublobar resections. Although in all cases margins were diagnosed as cancer free based on HE staining of frozen sections, two of four patients diagnosed with malignant-positive margins based on rapid ICC experienced local/margin recurrence.ConclusionsRapid-stapler lavage ICC with AC mixing could potentially serve as a clinical tool for prompt determination of margin malignant status after pulmonary sublobar resection.
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