- 期刊
Diagnostic Accuracy of Smear Biopsy and Frozen Section Examination in Neurosurgery
抺片活體檢視及冷凍切片檢查應用於神經外科手術之診斷準確性
摘要
快速組織病理診斷，意即抺片活體檢視或冷凍切片檢查，應用在進行中的手術，已經有長久的歷史。其重要性在開顱或脊膸手術當中，更是倍為強調。 從1983年7月起，本文共搜集93例取自神經外科手術的組織標本，同時施以抺片及冷凍切片檢查，主要之目的如下： （一） 腫瘤之存在有否。 （二） 原發性或繼發性病變。 （三） 惡性度之決定。 （四） 兩種診斷方式正確率之比較。 結果顯示，冷凍切片之診斷準確率（95.7%）較高於抺片法(84.9%)。儘管在錯誤的診斷中，前者有2例（2.2%），後者有8例（8.6%），可能導致醫師在進行中的手術裏作下偏差的判斷，總體而言，快速組織診斷仍是一種信賴度極高的技巧。其準確率之提昇，除須具備完整的臨床資料外，更有賴於神經病理及神經外科醫師間的密切合作。 部分特殊診斷上的難題及錯誤，本文一併詳加討論。
關鍵字
無資料並列摘要
93 neurosurgical biopsies by open craniotomy or spinal surgery over a period of 2 years, starting from July, 1983, were reviewed. The specimens were sent, unfixed, to the laboratory of pathology, where part was prepared for both frozen section an direct smear, while the rest was kept for subsequent paraffin sections. The diagnostic accuracy, based on final paraffin sections, was 95.7 percent in frozen sections and 84.7 per cent in smear examination, respectively. The comparison between the results of the two rapid tissue diagnoses was presented, and the errors were discussed in great detail. Though there were 2 biopsies(2.2 per cent )in the series which might have affected the immediate management of the patient, the rapid tissue diagnosis - frozen sections and smears – considerably facilitates neurosurgeons in making a further management decision while the patient is still on the operating table, and proves to be a very useful and reliable procedure.