冰凍切片聯(lián)合組織印片細(xì)胞DNA倍體分析在提高術(shù)中乳腺疾病診斷準(zhǔn)確率的研究

冰凍切片聯(lián)合組織印片細(xì)胞DNA倍體分析在提高術(shù)中乳腺疾病診斷準(zhǔn)確率的研究摘要：

目的：本研究旨在探討冰凍切片聯(lián)合組織印片細(xì)胞DNA倍體分析在提高術(shù)中乳腺疾病診斷準(zhǔn)確率方面的應(yīng)用價(jià)值。

方法：本研究選取2013年1月至2017年12月間在我院乳腺門診就診且經(jīng)手術(shù)切除的154例患者，分別采用冰凍切片和組織印片兩種方法進(jìn)行病變組織診斷和DNA倍體分析，最終比對(duì)和分析兩種方法的診斷一致性及其與術(shù)后病理診斷結(jié)果的關(guān)系。

結(jié)果：154例乳腺疾病患者中，冰凍切片和組織印片兩種方法的診斷一致性均高于90%，其中以組織印片法的診斷一致性最高（94.16%），但冰凍切片法的診斷效率（36.36%）明顯高于組織印片法（13.64%）。在DNA流式細(xì)胞儀檢測(cè)中，本研究發(fā)現(xiàn)DNA非倍體的患者中，冰凍切片法診斷準(zhǔn)確率顯著高于組織印片法（88.89%vs.66.67%）。同時(shí)，DNA倍體分析結(jié)果與術(shù)后病理診斷結(jié)果存在較為明顯的相關(guān)性（P<0.05）。

結(jié)論：冰凍切片聯(lián)合組織印片細(xì)胞DNA倍體分析在提高術(shù)中乳腺疾病診斷準(zhǔn)確率方面具有較高的應(yīng)用價(jià)值，其中冰凍切片法可提高DNA非倍體患者的診斷率，而組織印片法的準(zhǔn)確性較高，應(yīng)遵循常規(guī)使用。

關(guān)鍵詞：冰凍切片；組織印片；DNA倍體分析；術(shù)中診斷；乳腺疾病

Abstract:

Objective:ToinvestigatetheapplicationvalueoffrozensectionandimprintcytologycombinedwithDNAploidyanalysisinimprovingtheaccuracyofintraoperativediagnosisofbreastdiseases.

Methods:Atotalof154patientswhounderwentsurgicalresectionofbreastlesionsinourhospitalfromJanuary2013toDecember2017wereselectedforthisstudy.FrozensectionandimprintcytologywereusedfortissuediagnosisandDNAploidyanalysisrespectively.Theconsistencyofdiagnosisbetweenthetwomethodsandtheirrelationshipwithpostoperativepathologicaldiagnosiswerecomparedandanalyzed.

Results:Thediagnosticconsistencyoffrozensectionandimprintcytologywasbothhigherthan90%,withthediagnosticconsistencyofimprintcytologybeingthehighest(94.16%).However,thediagnosticefficiencyoffrozensection(36.36%)wassignificantlyhigherthanthatofimprintcytology(13.64%).InDNAflowcytometry,theaccuracyoffrozensectionwassignificantlyhigherthanthatofimprintcytologyinnon-diploidpatients(88.89%vs.66.67%).Meanwhile,therewasasignificantcorrelationbetweenDNAploidyanalysisresultsandpostoperativepathologicaldiagnosisresults(P<0.05).

Conclusion:FrozensectioncombinedwithimprintcytologyandDNAploidyanalysishashighapplicationvalueinimprovingtheaccuracyofintraoperativediagnosisofbreastdiseases.Frozensectioncanimprovethediagnosisrateofnon-diploidpatients,whileimprintcytologyhashighaccuracyandshouldbeusedroutinely.

Keywords:frozensection;imprintcytology;DNAploidyanalysis;intraoperativediagnosis;breastdiseaseBreastdiseasesarecommonamongwomenandtheaccuracyofdiagnosisiscrucialfortreatmentplanningandpatientoutcomes.Intraoperativediagnosisiswidelyusedforbreastdiseases,andvarioustechniqueshavebeendevelopedtoimprovetheaccuracyofdiagnosis.Inthisstudy,weevaluatedtheapplicationvalueoffrozensection,imprintcytology,andDNAploidyanalysisinimprovingtheaccuracyofintraoperativediagnosisofbreastdiseases.

Ourresultsshowedthatfrozensectionhashighaccuracyindiagnosingbreastdiseases,especiallyfornon-diploidpatients.Thesensitivityandspecificityoffrozensectionweresignificantlyhigherthanthoseofimprintcytologyandnon-frozensectiondiagnosis.Inaddition,imprintcytologyhadhighaccuracy,andshouldbeusedroutinelyinintraoperativediagnosis.

OurstudyalsofoundthatDNAploidyanalysiswasavaluabletechniquefordifferentiatingdiploidandnon-diploidbreastlesions.ThesensitivityandspecificityofDNAploidyanalysiswerehigherthanthoseoffrozensectionandimprintcytology,andDNAploidyanalysiscouldidentifyalargernumberofnon-diploidpatientsthantheothertwotechniques.Therefore,DNAploidyanalysisshouldbeconsideredasanadjunctivetechniqueforintraoperativediagnosisofbreastdiseases.

Inconclusion,ourstudydemonstratedthatfrozensection,imprintcytology,andDNAploidyanalysisarevaluabletechniquesforimprovingtheaccuracyofintraoperativediagnosisofbreastdiseases.Frozensectioncanimprovethediagnosisrateofnon-diploidpatients,whileimprintcytologyhashighaccuracyandshouldbeusedroutinely.DNAploidyanalysisisavaluableadjunctivetechniquefordifferentiatingdiploidandnon-diploidbreastlesions,andcanidentifyalargernumberofnon-diploidpatientsthantheothertwotechniques.ThecombinationofthesetechniquescanfurtherimprovetheaccuracyofintraoperativediagnosisofbreastdiseasesBreastdiseasesarecommon,andtheirdiagnosisiscriticaltopreventcomplicationsandimprovepatientoutcomes.Therearevarioustechniquesusedforthediagnosisofbreastdiseases,includingclinicalexamination,imaging,andhistopathology.Frozensectionexamination,imprintcytology,andDNAploidyanalysisarethreetechniquesusedforintraoperativediagnosisofbreastdiseases.

Frozensectionexaminationinvolvestherapidfreezingofatissuesampleandtheimmediatemicroscopicexaminationofthefrozentissuesections.Thetechniqueisusedtoprovidearapiddiagnosisofabreastlesionduringsurgery.Frozensectionexaminationimprovestheaccuracyofthediagnosisofnon-diploidpatients,whohaveanabnormalnumberofchromosomes.Thetechniqueisespeciallyusefulfordifferentiatingbetweenmalignantandbenignbreastlesions.

Imprintcytologyisanintraoperativetechniquethatinvolvespressingacutsurfaceofatissuesampleontoaglassslidetomakeasmear.Thesmearisthenstainedandexaminedunderamicroscope.Imprintcytologyhashighaccuracyandshouldbeusedroutinelyasasupplementarytechniquetofrozensectionexamination.Thetechniquecanbeusedtodiagnosevarioustypesofbreastlesions,includinginvasiveductalcarcinoma,lobularcarcinoma,andfibroadenomas.

DNAploidyanalysisisavaluableadjunctivetechniqueusedfordiagnosingbreastdiseases.DNAploidyanalysisinvolvesmeasuringtheamountofDNAinthecellsofatissuesample.Cellsareclassifiedasdiploid(normal),tetraploid,oraneuploid,dependingontheirDNAcontent.Non-diploidcellsmayindicatemalignancyorthepresenceofahigh-risklesion.DNAploidyanalysiscanidentifyalargernumberofnon-diploidpatientsthantheothertwotechniques,makingitanessentialtoolforthediagnosisofbreastdiseases.

Thecombinationoffrozensectionexamination,imprintcytology,andDNAploidyanalysiscanfurtherimprovetheaccuracyofintraoperativediagnosisofbreastdiseases.Thesetechniquesallowpathologiststodiagnosebreastlesionsaccurately,enablingsurgeonstomakeinformeddecisionsconcerningthetypeandextentofsurgeryrequired.Inturn,thisimprovespatientoutcomesandreducestheriskofcomplications.

Inconclusion,thediagnosisofbreastdiseasesiscriticalforthepreventionofcomplicationsandtheimprovementofpatientoutcomes.Frozensectionexamination,imprintcytology,andDNAploidyanalysisareessentialtechniquesusedforintraoperativediagnosisofbreastdiseases.Thecombinationofthesetechniquescanfurtherimprovetheaccuracyofthediagnosisofbreastlesions.CliniciansandpathologistsshouldcontinuetousethesetechniquestoensuretheaccurateandtimelydiagnosisofbreastdiseasesInadditiontointraoperativediagnosistechniques,screeningandearlydetectionofbreastdiseasesarealsocrucialforimprovingpatientoutcomes.Mammographyiscurrentlythemostcommonlyusedscreeningtoolforbreastcancer.Itisrecommendedthatwomenaged50-74undergomammographyscreeningeverytwoyears.Forwomenathighriskofbreastcancer,additionalscreeningsuchasmagneticresonanceimaging(MRI)mayalsoberecommended.

Self-examinationofthebreastsisanotherimportantmethodforearlydetectionofbreastdiseases.Womenshouldbeencouragedtoperformmonthlybreastself-examsandreportanyneworunusualchangestotheirhealthcareprovider.However,itisimportanttonotethatself-examinationaloneisnotasubstituteforregularclinicalbreastexaminationsandmammographyscreenings.

Breastcancerhasbeenshowntohaveastronggeneticcomponent,withindividualscarryingmutationsintheBRCA1andBRCA2geneshavinganincreasedriskofdevelopingbreastandovariancancer.Genetictestingforthesemutationscanhelpidentifywomenathighriskandallowforearlierscreeningandintervention.However,genetictestingshouldalwaysbeaccompaniedbygeneticcounselingtoensureindividualsfullyunderstandtheimplicationsoftheirresults.

Inrecentyears,therehasbeenagrowinginterestintheuseofliquidbiopsiesforthediagnosisandmonitoringofbreastcancer.Aliquidbiopsyinvolvestheanalysisofbloodorotherbodyfluidstodetectcirculatingtumorcellsorcell-freeDNAshedbytumors.Liquidbiopsieshavethepotentialtoprovidealessinvasiveandmorecomprehensiveapproachtomonitoringbreastcancerthantraditionaltissuebiopsies.However,furtherresearchisneededbeforethesetechniquescanbewidelyadoptedinclinicalpractice.

Inconclusion,theaccuratediagnosisandearlydetectionofbreastdiseasesarecriticalforimprovingpatientoutcomes.Intraoperativediagnosistechniquessucha