Novel 16-minute technique for evaluating melanoma resection margins during Mohs surgery - 10/08/11
Abstract |
Background |
Immunohistochemistry (IHC) applied to Mohs micrographic surgery (MMS) is time consuming and labor intensive, and the variability of staining quality has prevented its widespread use in clinical practice.
Objective |
To investigate the readability of immunostains processed by a novel automated 16-minute technique used for evaluation of frozen sections prepared during MMS for melanoma.
Methods |
A rapid automated instrument that performs MART-1 (melanoma antigen recognized by T cells) immunostains in 16 minutes was used to stain frozen sections and was compared with MART-1 stains of paraffin (permanent) sections, hematoxylin-eosin (H&E) stains of frozen and permanent sections from the positive or negative control specimens of the Mohs layers for melanoma. A total of 480 interpretations from 48 sections (4 types of stains for each specimen, 12 specimens read by 10 interpreters) were analyzed via blinded examination by 5 dermatopathologists and 5 Mohs surgeons at two institutions. A scoring system was used to assess the readability of each slide. Analysis of variance was used for statistical analysis.
Results |
In terms of clarity of interpreting melanoma sections, the 16-minute MART-1 IHC of frozen sections is equivalent to the standard MART-1 of permanent sections. The 16-minute MART-1 sections are also significantly easier to interpret than permanent sections stained with H&E for both the dermatopathologists and Mohs surgeons (P < .05).
Limitations |
The study represents data collected from only two institutions in the United States.
Conclusion |
The rapid-stained frozen IHC sections are significantly easier to interpret than the “gold standard” permanent sections stained with H&E. This technology facilitates the rapid interpretation of melanoma in frozen sections.
Le texte complet de cet article est disponible en PDF.Key words : immunohistochemistry, melanocyte, melanoma, Mohs micrographic surgery
Abbreviations used : H&E, IHC, MART-1, MMS
Plan
Funding sources: None. |
|
Conflicts of interest: None declared. |
Vol 64 - N° 1
P. 107-112 - janvier 2011 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?