For citation: Belova I., Breuninger H. The advantages of three-dimensional histology in comparison with conventional histology. Head and neck Russian Journal. 2019;7(1):47–58 (in Russian).
Doi: 10.25792/HN.2019.7.1.47–58
Routine histological examination of specimen using parallel cuts usually skips the areas between the sections, which increases the risk of incomplete tumor removal along the resection margin and, therefore, worsens patient outcomes. To ensure the detection of tumor cells in the surgical resection margin, the specimen should beprepared by 3D histology, with the separation of the thin strip from the vertical outer edge (marginal slice), then a thin layer of the lower part (basic slice), and finally a cross section of the remaining middle part (middle slice). Marginal and basic slices are to be examined for the presence of tumor cells, while the middle slice determines the morphological type of tumor.
The purpose of the study: a comparison of the effectiveness of 3D histology and conventional histology for the specimen examination using a mathematical model. Material and methods. Surgical cylinder shaped specimens of 18 various sizes (1 cm, 2, 3, 5, 7, 10 cm in diameter and 0.5 cm, 1.0 and 1.5 cm in height) were examined. Surgical materials were obtained in Moscow clinical dispensary #1. Specimens with ≤2 cm in diameter were studies using conventional histology, and specimens with >2 cm – using 3D histology. The proportions of the studied areas in 3D and conventional histology were calculated and compared, the percentage of the effective examination area (to determine the tumor type and identify tumor cells along the resection margin) was specified.
Results. Conventional histology provides a revision of the resection margins by only 0.02–0.2%, and 3D histology – by 85–100%. Conventional histology with five serial sections leads to 70-75% of working time and agents waste, and with nine serial sections — to almost 87% of waste.
Conclusions. Conventional histology does not guarantee the detection of tumor burdens in the resection margins and does not protect the patient from recurrence after surgical removal of the tumor. It is more reasonable to use 3D-histology for the examination of the removed material.
Keywords: three-dimensional histology, malignant neoplasms, cancer, skin malignant neoplasms, skin cancer, microscopically controlled surgery.
The authors declare no conflict of interest. Source of financing: not specified.
For citation: Belova I., Breuninger H. The advantages of three-dimensional histology in comparison with conventional histology. Head and neck Russian Journal. 2019;7(1):47–58 (in Russian).
The authors are responsible for the originality of the data presented and the possibility of publishing illustrative material – tables, figures, photographs of patients.