Background

The success of Mohs micrographic surgery depends on the surgeon’s ability to correctly interpret intraoperative frozen sections.

Objective

This retrospective study analyzed the rate of concordance between Mohs surgeons and dermatopathologists in reading slides from Mohs surgery cases.

Methods

A dermatopathologist reviewed all the frozen sections and the corresponding Mohs map for every 30th Mohs case at a practice employing 6 different Mohs surgeons during 2001-2017. Cases in which the dermatopathologist and the Mohs surgeon disagreed on the interpretation were noted.

Results

The concordance rate between Mohs surgeons and dermatopathologists was 99.79%. The 3 discordant cases included a case of squamous cell carcinoma, a case of superficial basal cell carcinoma, and a case of hypertrophic squamous cell carcinoma in situ.

Limitations

This analysis is limited to fellowship-trained Mohs surgeons and, therefore, might not be applicable to all physicians who perform Mohs.

Conclusion

Fellowship-trained Mohs surgeons show high concordance with board-certified dermatopathologists in the accurate and precise interpretation of histology slides in the setting of Mohs micrographic surgery.

中文翻译：

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莫氏显微手术和皮肤病理学一致性：对 17 年 1421 例莫氏病例的分析

背景

莫氏显微手术的成功取决于外科医生正确解读术中冰冻切片的能力。

客观的

这项回顾性研究分析了莫氏外科医生和皮肤病理学家在阅读莫氏手术病例幻灯片时的一致性率。

方法

一位皮肤病理学家在 2001-2017 年间聘请了 6 名不同的莫氏外科医生，检查了每 30 例莫氏病例的所有冰冻切片和相应的莫氏图。记录了皮肤病理学家和莫氏外科医生不同意解释的案例。

结果

莫氏外科医生和皮肤病理学家之间的一致性率为 99.79%。3例不一致的病例包括1例鳞状细胞癌、1例浅表基底细胞癌和1例肥大性鳞状细胞原位癌。

限制

该分析仅限于受过研究金培训的莫氏外科医生，因此可能不适用于所有进行莫氏手术的医生。

结论

受过奖学金培训的莫氏外科医生在莫氏显微手术环境中对组织学载玻片的准确和精确解释显示出与委员会认证的皮肤病理学家的高度一致性。