BACKGROUND:Oral squamous cell carcinoma (OSCC) is a multifactorial malignant epithelial neoplasm. Tumor clearance at the surgical margins in OSCC is a critical factor which strongly influences both the local recurrence and overall survival rate. A quick and accurate intraoperative diagnostic procedure can make a significant difference to the survival rate. Touch imprint cytology (TIC) has commonly been used in the past for the diagnosis of tumors and the detection of sentinel lymph node metastasis. It is routinely applied for intraoperative margin analysis of breast lumpectomy specimens, where it has been proven to have a good success rate. The effectiveness and reliability of TIC in the intraoperative margin evaluation of OSCC, however, has not been established so far. OBJECTIVE:To investigate the diagnostic accuracy of the intraoperative TIC technique for assessing surgical margins in OSCC in comparison to paraffin-embedded hematoxylin and eosin-stained sections. MATERIALS AND METHODS:Thirty previously untreated, biopsy-proven OSCC patients undergoing surgical treatment between December 2008 and September 2010 were included. Patients diagnosed with histological variants of squamous cell carcinoma (SCC) or recurrent tumor were excluded. Three hundred forty-eight touch imprint slides were prepared from 174 margins of 30 resected tumor specimens. Imprints from tumor proper were taken as positive controls. The slides were reported as positive, negative or suspicious for tumor. After all cytological interpretation was completed, the results were compared with the corresponding histological diagnosis. RESULTS:This pioneer study showed that TIC has an overall accuracy of 83%, sensitivity of 91.1%, specificity of 74.4%, positive predictive value of 79.2% and a negative predictive value of 88.6%. The false-positive margins evaluated by TIC were 43 (12.3%) and the false-negative ones were 16 (4.6%). CONCLUSION:TIC is a quick, simple, inexpensive, highly accurate and reliable intraoperative technique to assess surgical margins in SCC of the oral cavity.

译文

背景:口腔鳞状细胞癌(OSCC)是一种多因素恶性上皮性肿瘤。 OSCC手术边缘的肿瘤清除率是一个重要因素,它会严重影响局部复发和总体生存率。快速准确的术中诊断程序可以对生存率产生重大影响。过去,触摸印记细胞学(TIC)通常用于诊断肿瘤和检测前哨淋巴结转移。它通常用于乳腺肿块切除术标本的术中边缘分析,已被证明具有良好的成功率。迄今为止,TIC在OSCC术中切缘评估中的有效性和可靠性尚未建立。
目的:与石蜡包埋的苏木精和伊红染色切片比较,探讨术中TIC技术评估OSCC手术切缘的诊断准确性。
材料与方法:纳入30例2008年12月至2010年9月间接受手术治疗且未经活检证实的OSCC患者。诊断为鳞状细胞癌(SCC)或复发性肿瘤的组织学变异的患者被排除在外。从30个切除的肿瘤标本的174个空白处制备了348个触摸式印记载玻片。来自肿瘤固有的印记被用作阳性对照。据报载玻片对肿瘤呈阳性,阴性或可疑。完成所有细胞学解释后,将结果与相应的组织学诊断结果进行比较。
结果:这项先驱研究表明,TIC的总体准确度为83%,敏感性为91.1%,特异性为74.4%,阳性预测值为79.2%,阴性预测值为88.6%。 TIC评估的假阳性利润率为43(12.3%),假阴性利润率为16(4.6%)。
结论:TIC是一种快速,简单,廉价,高度准确和可靠的术中技术,可用于评估口腔SCC的手术切缘。

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