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The usefulness and problem of intraoperative rapid diagnosis in surgical neuropathology

机译：术中快速诊断在外科神经病理学中的有用性和问题

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Intraoperative rapid diagnosis has been a useful neurosurgery tool for maximal resection and minimal morbidity. However, only a few studies have been conducted regarding diagnostic accuracy and associated problems. The present study reviews our experience in treating patients and investigates the accuracy and problems associated with intraoperative rapid diagnosis in surgical neuropathology. There were 180 cases of intracranial lesions excluding pituitary lesions. The patients consisted of 89 males and 91 females, ranging from 5 months to 84 years, with a mean age of 46 years. Of the 180 cases, 152 cases received open surgery, 28 cases had stereotactic surgery including a biopsy and were histologically verified. The correlation between the intraoperative diagnosis and the final diagnosis overall was seen in 172 of 180 cases, proving a high diagnostic sensitivity of 95.6%. No correlation was seen in 8 cases (4.4%). The diagnostic inaccuracy was seen in the grading of gliomas and the diagnosis of undifferentiated malignant tumors such as undifferentiated metastatic carcinomas, primitive neuroectodermal tumors (PNETs), and sarcomas. It was also recognized in rare types of histology such as gliomatosis and xanthomatous lesions. These results suggested that the intraoperative rapid diagnosis was quite useful, but that we should also maintain a cautious attitude.
机译：术中快速诊断一直是最大切除和最小发病率的有用的神经外科工具。但是，关于诊断准确性和相关问题仅进行了很少的研究。本研究回顾了我们在治疗患者方面的经验，并探讨了在外科神经病理学中与术中快速诊断相关的准确性和问题。有180例颅内病变，不包括垂体病变。患者包括89例男性和91例女性，年龄从5个月到84岁不等，平均年龄为46岁。在180例中，有152例接受了开放手术，其中28例接受了包括活检在内的立体定向手术，并进行了组织学检查。术中诊断与最终诊断总体之间的相关性在180例病例中的172例中可见，被证明具有95.6％的高诊断敏感性。 8例（4.4％）未发现相关性。在神经胶质瘤的分级和未分化的恶性肿瘤（如未分化的转移性癌，原始神经外胚层肿瘤（PNET）和肉瘤）的诊断中发现了诊断的不准确性。在罕见的组织学类型（例如胶质瘤病和黄瘤病灶）中也认识到了这一点。这些结果表明，术中快速诊断是很有用的，但我们也应保持谨慎的态度。

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