冰凍切片活檢具有若幹優越性,歐美各國並未揚棄冰凍活檢。參見 JAMA 12-28, 2005

來源: 禦用文人 2014-11-17 01:06:04 [] [舊帖] [給我悄悄話] 本文已被閱讀: 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: 

文章有點老啊。2005年。 -26484915- 給 26484915 發送悄悄話 26484915 的博客首頁 (0 bytes) () 11/17/2014 postreply 04:12:34

哈哈哈!你能找到更新的意見不一樣的嗎? -禦用文人- 給 禦用文人 發送悄悄話 (0 bytes) () 11/17/2014 postreply 09:43:54

謝謝!新不意味著更好。不是有人活檢後器官還被割得稀裏胡塗的嗎?這樣的治療還真要有堅定的信仰做支撐。 -tournier- 給 tournier 發送悄悄話 tournier 的博客首頁 (6 bytes) () 11/17/2014 postreply 04:25:37

腦瘤手術裏用得不少。畢竟開一次顱是大手術,而且腫瘤邊界要盡量切得精準才好。 -viewfinder- 給 viewfinder 發送悄悄話 viewfinder 的博客首頁 (0 bytes) () 11/17/2014 postreply 04:48:23

所以經常要 intraoperative consultation standby -viewfinder- 給 viewfinder 發送悄悄話 viewfinder 的博客首頁 (0 bytes) () 11/17/2014 postreply 05:06:05

我兒子在神經手術輪轉時根我說過。 -老子說兩句- 給 老子說兩句 發送悄悄話 (296 bytes) () 11/17/2014 postreply 05:33:46

Neurosurgeon的專科培訓是時間最長的. -閩姑- 給 閩姑 發送悄悄話 閩姑 的博客首頁 (0 bytes) () 11/17/2014 postreply 05:52:54

上回有病人邊被開腦邊拉小提琴的。病人是一位小提琴家。 -見風是雨- 給 見風是雨 發送悄悄話 (0 bytes) () 11/17/2014 postreply 06:28:51

做神外需要超人,有時候一台手術要十個小時。而且醫學院畢業以後各種培訓加起來都快十年了,十年磨一劍的感覺。 -viewfinder- 給 viewfinder 發送悄悄話 viewfinder 的博客首頁 (111 bytes) () 11/17/2014 postreply 06:38:14

+1! -老子說兩句- 給 老子說兩句 發送悄悄話 (0 bytes) () 11/17/2014 postreply 06:48:54

當因手術意外,患者癱瘓,外科醫生仍要蛋定,非超人能麵對這種局麵... -Lilac2003- 給 Lilac2003 發送悄悄話 Lilac2003 的博客首頁 (0 bytes) () 11/17/2014 postreply 07:22:25

+1!用在術中定腫瘤邊界,有些免化染色等等也要冰凍 -誌在千裏- 給 誌在千裏 發送悄悄話 (151 bytes) () 11/17/2014 postreply 07:37:24

不能作為取代術前的活檢吧,因為有人說不做活檢,手術時做冰凍切片就可以了。 -betadine- 給 betadine 發送悄悄話 (0 bytes) () 11/17/2014 postreply 09:37:26

讚同. 你是對的. -閩姑- 給 閩姑 發送悄悄話 閩姑 的博客首頁 (0 bytes) () 11/17/2014 postreply 09:40:45

腦瘤怎麽做術前活檢???我孤陋寡聞了,願聞期詳 -Diana-Sun- 給 Diana-Sun 發送悄悄話 Diana-Sun 的博客首頁 (0 bytes) () 11/17/2014 postreply 10:12:13

腦腫瘤因位置原因有時候不得不做open biopsy,活檢和手術是同時進行。這時候一般第一個sample去做冷凍切片, -viewfinder- 給 viewfinder 發送悄悄話 viewfinder 的博客首頁 (105 bytes) () 11/17/2014 postreply 10:13:34

同意您的。具體問題具體分析。 -Diana-Sun- 給 Diana-Sun 發送悄悄話 Diana-Sun 的博客首頁 (0 bytes) () 11/17/2014 postreply 10:17:36

是地,這個優越性十分重要。。。 -禦用文人- 給 禦用文人 發送悄悄話 (0 bytes) () 11/17/2014 postreply 10:50:54

在手術台上做冰凍切片活檢以後,通常還會留下一些組織做常規病理切片, 以後驗證兩者的病理診斷是否一致。 -禦用文人- 給 禦用文人 發送悄悄話 (0 bytes) () 11/17/2014 postreply 10:05:17

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