Objective

Sublobar resection is considered the gold standard for selected patients with pulmonary metastasis or who are compromised in some way. However, an unfavorable outcome after sublobar resection is local/margin recurrence. The aim of this study was to evaluate the clinical reliability of a new rapid-stapler lavage immunocytochemistry (ICC) technique for assessing margin malignancy. The method uses non-contact alternating current (AC) mixing to achieve more stable staining.

Methods

Twenty-one patients who underwent sublobar resection, including 16 wedge resections, for pulmonary metastasis or lung cancer in a compromised host between September 2016 and December 2017 were retrospectively reviewed. All margin specimens were intraoperatively evaluated with HE staining of frozen sections and stapler lavage cytology using Papanicolaou staining and rapid-ICC.

Results

Rapid-stapler lavage ICC can be used to diagnose surgically safe margins within 20 min during sublobar resections. Although in all cases margins were diagnosed as cancer free based on HE staining of frozen sections, two of four patients diagnosed with malignant-positive margins based on rapid ICC experienced local/margin recurrence.

Conclusions

Rapid-stapler lavage ICC with AC mixing could potentially serve as a clinical tool for prompt determination of margin malignant status after pulmonary sublobar resection.

中文翻译：

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吻合器灌洗细胞学使用新的快速免疫细胞化学评估肺亚肺叶切除术后切缘状态

客观的

亚肺叶切除被认为是选定的肺转移患者或以某种方式受到损害的患者的金标准。然而，亚肺叶切除术后的不利结果是局部/边缘复发。本研究的目的是评估一种新的快速吻合器灌洗免疫细胞化学 (ICC) 技术用于评估边缘恶性肿瘤的临床可靠性。该方法使用非接触式交流 (AC) 混合来实现更稳定的染色。

方法

回顾性分析了 2016 年 9 月至 2017 年 12 月期间在受损宿主中接受亚肺叶切除术（包括 16 例楔形切除术）的 21 例肺转移或肺癌患者。所有边缘标本在术中通过冰冻切片的 HE 染色和使用巴氏染色和快速 ICC 的吻合器灌洗细胞学进行评估。

结果

快速吻合器灌洗 ICC 可用于在亚肺叶切除期间 20 分钟内诊断手术安全边缘。尽管在所有病例中，根据冰冻切片的 HE 染色，切缘被诊断为无癌，但根据快速 ICC 诊断为切缘恶性阳性的 4 名患者中，有 2 人经历了局部/切缘复发。

结论

与 AC 混合的快速吻合器灌洗 ICC 可能作为一种临床工具，用于在肺亚肺叶切除后迅速确定边缘恶性状态。