During the surgical procedure, the doctor will diagnose the benign and malignant resection of the tumor by quickly freezing the slices, so as to make the next step of treatment. But we will find in the clinic that sometimes frozen slices and paraffin slices have different results, so why is this happening?
Frozen sectioning is a method of rapidly cooling tissue to a certain hardness under low temperature conditions and then performing sectioning. Frozen slices generally provide a pathological report within 30 minutes. Because its production process is faster and easier than paraffin slices, it is mostly used for rapid pathological diagnosis in surgery.
Paraffin sectioning is the first need to cut the diseased tissue and organs for a series of technical treatment, including fixation, material extraction, dehydration, wax immersion, embedding, sectioning and staining, etc., generally it takes 24 hours to complete the entire filming process, and then by the pathologist with a microscope to observe, and make a diagnosis. This method of examination is called conventional paraffin sectioning and is the most commonly used method in pathological examination. However, this method usually takes 3 days from the surgeon cutting off the diseased tissue to making a pathological diagnosis.
1. What is the difference between frozen slices and paraffin slices?
First, frozen sections are frozen to obtain hardness and thus made of slices, unlike paraffin sections, it has not been fully dehydrated, the observation of tissues will have a certain impact, the general accuracy of freezing is 95%, while paraffin wax can reach more than 98%.
Second, intraoperative freezing requires 30 minutes to produce results, and the production takes time, so there is a limit to the number of materials, the tissue sent for examination is three-dimensional, some lesions cannot be observed by the naked eye, the material can only be random, if the diseased tissue cannot be taken in a limited number, it will affect the final report.
Third, the surgeon sent too little tissue, a 5cm diameter of the mass only sent 0.5cm size, sometimes will not be taken to the lesion site, or did not send the most critical part of the benign and malignant lesions to identify, but after the operation of the general specimen after a number of places of sufficient material can generally take the diseased tissue, but also will cause the difference in freezing and paraffin results.
2. Why do frozen slices are done during surgery?
Sometimes the surgeon wants to understand the nature of the lesion immediately during the operation, in order to determine the scope of surgery in time, and make corresponding treatment, the correctness of the pathological diagnosis is directly related to the next step on the operating table to treat the patient, such as the frozen report after the removal of the breast mass is a benign fibroadenoma, the end of the operation can be declared; if the freezing report is breast cancer, it is necessary to further expand the scope of surgery, remove the entire breast and armpit lymph nodes; malignant tumors of the limbs such as osteosarcoma, usually require amputation.
The pathological diagnosis of frozen slices is of great help and guiding significance for surgical treatment, and the diagnosis should strive to be correct, rapid and reliable. However, rapid frozen sectioning is quite difficult and risky to make a diagnosis in such a short period of time. Frozen slices are not a panacea, and there is a certain rate of delayed diagnosis and misdiagnosis. However, the choice of surgical solution is indispensable.
Third, rapid frozen sectioning is mainly used in the following situations: (1) to determine whether the lesion is a tumor; (2) to determine the benign and malignant nature of the tumor; (3) to know whether the tumor has spread to adjacent lymph nodes or organs; (4) to determine whether the surgical margin has tumor infiltration to understand whether the scope of surgery is large enough; (5) to help identify some accidents in the operation and to identify suspicious micro tissues (such as parathyroid glands, fallopian tubes or vas deferens, etc.) ;(6) to take fresh tissue for hormone receptor measurement, tumor susceptibility test, electron microscopy and molecular biology examination and other special needs.
Disclaimer: This article is reproduced for the purpose of transmitting more information. If there is a source labeling error or infringement of your legitimate rights and interests, please contact the author with the proof of ownership, we will correct and delete it in time, thank you.