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目的提高乳腺乳头状病变的术中诊断准确性,考察快速免疫组化检测技术在术中诊断中的应用。方法采用多聚辣根过氧化物酶直接标记的抗体CK5和SMMHC,进行冷冻切片快速免疫组化(IHC)染色,以石蜡切片的诊断结果为金标准,对常规冷冻切片诊断与快速诊断进行评价和比较。结果本组90例冷冻诊断包括,69例导管内乳头状瘤,3例乳头状瘤合并导管原位癌(DCIS),3例未明确具体类型癌,1例导管内实性乳头状癌,14例延迟诊断。快速IHC检测流程耗时约10 min,结合快速IHC的术中诊断准确率(98%)显著高于常规冷冻诊断(P<0.01),其假阴性率为0和延迟诊断率为2%,均显著低于常规冷冻诊断(P<0.01)。结论快速IHC可提高术中诊断准确性,符合诊断时限要求,常规应用于术中诊断的可行性较高。
Objective To improve the accuracy of intraoperative diagnosis of papillary papillary lesions and investigate the application of rapid immunohistochemical detection in intraoperative diagnosis. Methods Immunohistochemical staining (IHC) was performed on frozen sections of CK5 and SMMHC, which were directly labeled with horseradish peroxidase. The diagnostic results of paraffin sections were taken as the gold standard to evaluate the diagnosis and rapid diagnosis of routine frozen sections And compare. Results Ninety-nine cases of intraductal papilloma, three cases of papilloma with ductal carcinoma in situ (DCIS), three cases of definite type of carcinoma, one case of ductal papillary carcinoma and one case of ductal papillary carcinoma Cases delayed diagnosis. The rapid IHC detection process took about 10 min, and the intraoperative diagnostic accuracy (98%) in combination with rapid IHC was significantly higher than that in routine frozen diagnosis (P <0.01) with a false negative rate of 0 and a delayed diagnostic rate of 2% Significantly lower than the conventional frozen diagnosis (P <0.01). Conclusion Fast IHC can improve intraoperative diagnostic accuracy, meet the diagnostic time limit requirements, routinely used in intraoperative diagnosis is more feasible.