冰冻切片活检具有若干优越性,欧美各国并未扬弃冰冻活检。参见 JAMA 12-28, 2005

来源: 御用文人 2014-11-17 01:06:04 [] [旧帖] [给我悄悄话] 本文已被阅读: 次 (51660 bytes)
 
JAMA Patient Page | 

Frozen Section Biopsy FREE

Erin Brender, MD, Writer; Alison Burke, MA, Illustrator; Richard M. Glass, MD, Editor
JAMA. 2005;294(24):3200. doi:10.1001/jama.294.24.3200.
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Biopsies are small samples of tissue taken from a mass or tumor that are examined under a microscope to make a diagnosis. Biopsies are used most often to determine whether cancer cells are present, although certain infections and other diseases can be diagnosed as well. A specific type of biopsy procedure called thefrozen section was developed in order to make a rapid diagnosis of a mass during surgery. The December 28, 2005, issue of JAMA includes an article about the origins of the frozen section technique.

FROZEN SECTION PROCEDURE

During the frozen section procedure, the surgeon removes a portion of the tissue mass. This biopsy is then given to a pathologist (a doctor who examines tissues and uses laboratory tests to make a diagnosis). The pathologist freezes the tissue in a cryostat machine, cuts it with a microtome, and then stains it with various dyes so that it can be examined under the microscope. The procedure usually takes only minutes.

Image not available.

ADVANTAGES OF FROZEN SECTION BIOPSY

 

  • If more tissue is needed to make an accurate diagnosis, the surgeon is able to obtain an additional sample, avoiding a second operation.

  • If the tissue is determined to be cancerous and is amenable to surgery, the mass can be removed at that time.

  • If the tissue is determined to be benign (not cancerous), then the mass may not always need to be removed and the surgery can end.

  • The frozen section biopsy can help ensure that the mass being removed is the intended tissue for removal.

  • It can help ensure that the entire mass and its surrounding borders are removed.

  • It allows for the collection of proper tissue samples for further scientific research.

  • The surgeon and pathologist are able to collaborate to care for the patient.

 

Sometimes pathologists are not able to determine the diagnosis based on the frozen section and instead must rely on the permanent section. In this procedure the tissue is not frozen but instead is placed in a fixative solution, embedded in wax, thinly cut, and then stained. Although this takes longer than a frozen section (usually 1 day), the permanent section leads to better-quality microscope slides. All biopsies are limited by the sample taken. Cancer or other diseases may be so small that they are not present in the tissue sample but may still be present elsewhere. Multiple biopsies may be needed to make a diagnosis.

FOR MORE INFORMATION

 

 

INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site athttp://www.jama.com. Many are available in English and Spanish.

Source: Jacobs DS, DeMott WR, Oxley DK. Jacobs and DeMott Laboratory Test Handbook. 5th ed. Hudson, Ohio: Lexi-Comp Inc; 2001

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 718/946-7424.

TOPIC: TISSUE DIAGNOSIS

所有跟帖: 

文章有点老啊。2005年。 -26484915- 给 26484915 发送悄悄话 26484915 的博客首页 (0 bytes) () 11/17/2014 postreply 04:12:34

哈哈哈!你能找到更新的意见不一样的吗? -御用文人- 给 御用文人 发送悄悄话 (0 bytes) () 11/17/2014 postreply 09:43:54

谢谢!新不意味着更好。不是有人活检后器官还被割得稀里胡涂的吗?这样的治疗还真要有坚定的信仰做支撑。 -tournier- 给 tournier 发送悄悄话 tournier 的博客首页 (6 bytes) () 11/17/2014 postreply 04:25:37

脑瘤手术里用得不少。毕竟开一次颅是大手术,而且肿瘤边界要尽量切得精准才好。 -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (0 bytes) () 11/17/2014 postreply 04:48:23

所以经常要 intraoperative consultation standby -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (0 bytes) () 11/17/2014 postreply 05:06:05

我儿子在神经手术轮转时根我说过。 -老子说两句- 给 老子说两句 发送悄悄话 (296 bytes) () 11/17/2014 postreply 05:33:46

Neurosurgeon的专科培训是时间最长的. -闽姑- 给 闽姑 发送悄悄话 闽姑 的博客首页 (0 bytes) () 11/17/2014 postreply 05:52:54

上回有病人边被开脑边拉小提琴的。病人是一位小提琴家。 -见风是雨- 给 见风是雨 发送悄悄话 (0 bytes) () 11/17/2014 postreply 06:28:51

做神外需要超人,有时候一台手术要十个小时。而且医学院毕业以后各种培训加起来都快十年了,十年磨一剑的感觉。 -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (111 bytes) () 11/17/2014 postreply 06:38:14

+1! -老子说两句- 给 老子说两句 发送悄悄话 (0 bytes) () 11/17/2014 postreply 06:48:54

当因手术意外,患者瘫痪,外科医生仍要蛋定,非超人能面对这种局面... -Lilac2003- 给 Lilac2003 发送悄悄话 Lilac2003 的博客首页 (0 bytes) () 11/17/2014 postreply 07:22:25

+1!用在术中定肿瘤边界,有些免化染色等等也要冰冻 -志在千里- 给 志在千里 发送悄悄话 (151 bytes) () 11/17/2014 postreply 07:37:24

不能作为取代术前的活检吧,因为有人说不做活检,手术时做冰冻切片就可以了。 -betadine- 给 betadine 发送悄悄话 (0 bytes) () 11/17/2014 postreply 09:37:26

赞同. 你是对的. -闽姑- 给 闽姑 发送悄悄话 闽姑 的博客首页 (0 bytes) () 11/17/2014 postreply 09:40:45

脑瘤怎么做术前活检???我孤陋寡闻了,愿闻期详 -Diana-Sun- 给 Diana-Sun 发送悄悄话 Diana-Sun 的博客首页 (0 bytes) () 11/17/2014 postreply 10:12:13

脑肿瘤因位置原因有时候不得不做open biopsy,活检和手术是同时进行。这时候一般第一个sample去做冷冻切片, -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (105 bytes) () 11/17/2014 postreply 10:13:34

同意您的。具体问题具体分析。 -Diana-Sun- 给 Diana-Sun 发送悄悄话 Diana-Sun 的博客首页 (0 bytes) () 11/17/2014 postreply 10:17:36

是地,这个优越性十分重要。。。 -御用文人- 给 御用文人 发送悄悄话 (0 bytes) () 11/17/2014 postreply 10:50:54

在手术台上做冰冻切片活检以后,通常还会留下一些组织做常规病理切片, 以后验证两者的病理诊断是否一致。 -御用文人- 给 御用文人 发送悄悄话 (0 bytes) () 11/17/2014 postreply 10:05:17

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