Frozen section analysis of esophageal endoscopic mucosal resection specimens in the real-time management of Barrett's esophagus.
Frozen section analysis of esophageal endoscopic mucosal resection specimens in the real-time management of Barrett's esophagus.
复制标题
食管内镜下粘膜切除标本的冰冻切片分析在巴雷特食管的实时管理中。
DOI：
10.1016/j.cgh.2005.11.002
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Burgart,LawrenceJ
中科院分区：
文献类型：
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作者：
Prasad,GanapathyA;Wang,KennethK;Lutzke,LoriS;Lewis,JasonT;Sanderson,SchuylerO;Buttar,NavtejS;WongKeeSong,LouisM;Borkenhagen,LynnS;Burgart,LawrenceJ
Background & AimsThe aim of this study was to assess the validity of frozen section analysis of endoscopic mucosal resection (EMR) specimens from Barrett’s esophagus as compared with permanent sections for the detection of neoplasia. Frozen sections help to give immediate feedback for surgical procedures. It has not been determined whether EMR can be adequately interpreted by using frozen sections to aid endoscopists in completely resecting neoplastic lesions.MethodsEMR specimens from Barrett’s esophagus with high-grade dysplasia (HGD) and/or carcinoma were tested by frozen section. Pathologists evaluated EMR specimens for the depth of invasion as well as the appearance of clear margins of resection. The κ statistic was calculated to assess the degree of agreement between the frozen section and permanent section diagnoses.ResultsTwenty-three consecutive patients underwent 30 EMRs with frozen section diagnosis. Frozen section revealed a carcinoma in 7 specimens (23%) and dysplasia in 20 (66%). Permanent sections found carcinoma in 8 specimens (26%), dysplasia in 19 specimens (63%), and normal or nondysplastic Barrett’s esophagus in the remainder. The κ statistic for the depth of invasion of EMR specimens was 0.93 (near perfect agreement). The κ statistic for the margins of the EMR specimens was 0.80 (excellent agreement).ConclusionsThis study indicated that frozen section analysis of esophageal EMR specimens is valid as compared with permanent section. This technique might allow rapid evaluation about the degree and depth of involvement of cancers. This allows physicians to make decisions regarding further therapy if margins are involved or decrease the use of EMR for histologically benign–appearing lesions.
