术中冰冻病理在立体定向脑深部病变活检中的应用.

Objective To explore the application value of intraoperative frozen section analysis in stereotactic biopsy of brain lesions. Methods The clinical data of 44 patients with brain lesions from June 2015 to October 2021 were analyzed retrospectively. Intraoperative frozen pathology analysis was applied in all 46 procedures, immunohistochemical examination was applied if necessary. Regular pathological results were used as the gold standard for diagnosis, and the diagnostic rate, delayed diagnostic rate and misdiagnosis rate of frozen results were judged. The diagnostic positive rate, diagnostic coincidence rate and influencing factors of frozen pathology during operation were analyzed. Results Of the 44 patients who underwent 46 biopsies, 9 patients had negative results in the first intraoperative freezing, and 7 of them had positive results after adjusting the depth of puncture and re-biopsy. 23 patients were diagnosed by intraoperative immunohistochemistry. In the end, 44 patients (96.65%) had positive intraoperative freezing results, and the diagnostic accuracy rate was 91.3% （35 cases were confirmed+7 cases were delayed). The results of puncture biopsy included 27 cases of glioma (6 cases of WHO grade Ⅰ-Ⅱ, 21 cases of WHO grade Ⅲ-Ⅳ12cases of lymphoma, 4 cases of germinoma, and 1 case of amyloidosis. Conclusions Although intraoperative frozen pathology leads to more operation time consuming, it can quickly uncover the pathology of biopsy specimens, avoid excessive sampling improve operation efficiency and reduce surgical complications. Intraoperative frozen pathology can be applied in robot-assisted stereotactic brain lesion biopsy. [ABSTRACT FROM AUTHOR]