摘要
目的提高乳腺乳头状病变的术中诊断准确性,考察快速免疫组化检测技术在术中诊断中的应用。方法采用多聚辣根过氧化物酶直接标记的抗体CK5和SMMHC,进行冷冻切片快速免疫组化(IHC)染色,以石蜡切片的诊断结果为金标准,对常规冷冻切片诊断与快速诊断进行评价和比较。结果本组90例冷冻诊断包括,69例导管内乳头状瘤,3例乳头状瘤合并导管原位癌(DCIS),3例未明确具体类型癌,1例导管内实性乳头状癌,14例延迟诊断。快速IHC检测流程耗时约10 min,结合快速IHC的术中诊断准确率(98%)显著高于常规冷冻诊断(P<0.01),其假阴性率为0和延迟诊断率为2%,均显著低于常规冷冻诊断(P<0.01)。结论快速IHC可提高术中诊断准确性,符合诊断时限要求,常规应用于术中诊断的可行性较高。
Objective To improve intraoperative diagnostic accuracy of breast papillary lesions and to validate use of rapid direct immunohistochemistry（IHC） for intraoperative diagnosis.Methods Rapid direct IHC stains of CK5 and SMMHC antibodies directly labeled with horseradish peroxidase were performed on frozen section tissues and the intraoperative diagnostic results on frozen section tissues with or without rapid direct IHC stains were compared with final pathology diagnoses based on formalin fixed paraffin embed tissues（FFPE）.Results Total 90 cases were included in this study.Intraoperative diagnoses were as follows：69 cases of intraductal papilloma;3 cases of papilloma and carcinoma in situ（DCIS）;3 cases of cancer,unclear specific type;1 case of intraductal papillary carcinoma,14 cases of deferred diagnosis.All the rapid CK5 and SMMHC direct IHC stains were finished within 10 minutes.Comparing with intraoperative diagnoses based on conventional frozen section only,the combinations of frozen section and rapid intraoperative direct IHC had significantly improved intraoperative diagnostic accuracy to 98%（P〈0.01）,with zero percent false negative rate and they also significantly reduced deferred diagnosis rate to 2%（P〈0.01）.Conclusions Use of rapid direct IHC can significantly improve intraoperative diagnostic accuracy;Rapid direct IHC has fulfilled fast turn-around time requirements for intraoperative diagnosis,and it is feasible to be used routinely for intraoperative diagnosis.
出处
《诊断病理学杂志》
2017年第10期768-773,共6页
Chinese Journal of Diagnostic Pathology
关键词
乳头状癌
乳头状病变
冷冻诊断
免疫组化
Breast cancer
Papillary lesions
Intraoperative frozen section
Immunohistochemistry
