| 马慧,张淑红,赵建民,等.冷冻锤合理使用对提高肺部肿物术中肺组织冰冻切片质量及诊断的临床意义[J].安徽医药,2026,30(5):929-932. |
| 冷冻锤合理使用对提高肺部肿物术中肺组织冰冻切片质量及诊断的临床意义 |
| Clinical significance of rational use of cryopress to improve the quality and diagnosis of intraoperative frozen section in lung tissue |
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| DOI：10.3969/j.issn.1009-6469.2026.05.016 |
| 中文关键词: 冰冻切片 病理诊断 肺疾病 肺组织 冷冻锤 取材大小 诊断 |
| 英文关键词: Frozen section Pathologic diagnosis Lung diseases Lung tissue Freeze hammer Sample size Diagnosis |
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| 中文摘要: |
| 目的探索优化肺组织术中冰冻制片的方法，以提高肺部肿物临床诊断的准确率。方法选取 2024年 3—4月在首都医科大学附属北京友谊医院临床手术术中切除肺组织的冰冻标本 80例，根据取材组织的大小，分为三组，即取材后组织长径 < 10 mm的标本 10例； 10～<20 mm的标本 40例； ≥20 mm的标本 30例。在冰冻托上滴加适量冰冻包埋剂，将取材后的肺组织放置在冰冻托上，放入冰冻机中。待组织冷冻至 1/2时，使用冷冻锤加盖于组织上，加速速冻。根据冷冻锤使用时间分为 0s(即自然速冻)、 5s、10 s、15 s四组。待组织冻好后，粗修出组织最大面， 6 μm连续切片，黏附载玻片贴片，立即置于冰冻固定液中固定 5s，全自动冰冻切片染色机内完成常规苏木精 -伊红( HE)染色。结果当取材组织长径 <10 mm时，自然速冻后结果显示，切片组织完整，结构清晰，无冰晶产生。当取材组织长径 10～<20 mm时，在肺组织冷冻至 1/2时，使用冷冻锤 15 s后，冰冻切片的组织完整性的质量评分( 2.800±0.422)分、组织皱缩的质量评分( 2.900±0.316)分、组织是否有冰晶的质量评分( 2.900±0.316)分及核质对比度的质量评分( 2.900±0.316)分均显著高于未使用冷冻锤组及使用冷冻锤 5s、10 s三组，差异有统计学意义( P<0.05)。当取材组织长径 ≥20 mm时，在肺组织冷冻至 1/2时，使用冷冻锤 15 s后，冰冻切片的组织完整性的质量评分(2.800±0.422)分、组织皱缩的质量评分( 2.800±0.422)分、组织是否有冰晶的质量评分( 2.800±0.422)分及核质对比度的质量评分(2.800±0.422)分均显著高于未使用冷冻锤组及使用冷冻锤 10 s两组，差异有统计学意义( P<0.05)。结论在肺组织术中冰冻制片时，若冰冻取材组织 >10 mm时，待组织冷冻 1/2时，使用冷冻锤 15 s后切片，切片质量效果最佳，是术中诊断肺部肿物一种较为可靠的制片方法，有利于提高临床快速诊断的准确率。 |
| 英文摘要: |
| Objective To improve the accuracy of clinical diagnosis by exploring the method of optimizing the frozen section in lung tissue.Methods Eighty specimens of frozen lung tissue resected during clinical surgeries at Beijing Friendship Hospital, Capital Med.ical University from March to April 2024 were selected and assigned to 3 groups according to the size of the tissue: 10 specimens withthe maximum tissue diameter <10 mm, 40 with the maximum tissue diameter 10-<20 mm, and 30 ≥20 mm. Appropriate amount of fro.zen embedding agent was added to the chuck, and the lung tissues were placed on the chuck and then put into the cryostat. When thetissue was frozen to 1/2, a cryopress was used to cover the tissue to speed up freezing. According to the usage time of the cryopress, thetissue specimens were assigned to four groups: 0s (natural quick freezing), 5 s, 10 s and 15 s. After the tissue was completely frozen, thelargest surface was exposed by trimming. Serial sections of 6 μm thickness were cut and mounted on adhesive slides, and then immedi.ately placed in the frozen fixing solution for 5 s before routine HE staining was completed in the automatic frozen section staining ma.chine.Results When the maximum diameter of the tissue was less than 10 mm, the results of natural quick-freezing showed that thesliced tissue was complete with clear structure and no ice crystal. When the diameter of the tissue sample was 10 to <20 mm and thelung tissue was half-frozen, the quality scores for tissue integrity (2.800±0.422), tissue shrinkage (2.900±0.316), ice crystal formation(2.900±0.316), and nuclear-to-cytoplasmic contrast (2.900±0.316) in the group using the cryo-hammer for 15 s were significantly higherthan those in the group without cryopress use and the groups using cryopress for 5 s and 10 s; the differences were statistically signifi.cant (P<0.05). When the diameter of the tissue sample was ≥20 mm and the lung tissue was half-frozen, the quality scores for tissue in.tegrity (2.800±0.422), tissue shrinkage (2.800±0.422), ice crystal formation (2.800±0.422), and nuclear-to-cytoplasmic contrast (2.800±0.422) in the group using cryopress for 15 s were significantly higher than those in the group without cryopress use and the group usingcryopress for 10 s; the differences were statistically significant (P<0.05).Conclusions During the intraoperative frozen section of lung tissue, when the frozen tissue is >10 mm and the tissue is half-frozen, the section quality achieves the best if the cryopress is used for15 s prior to sectioning. Such section method serves as a reliable technique for the intraoperative diagnosis of lung lesions, which helpsimprove the accuracy of rapid clinical diagnosis. |
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