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Stapler-lavage cytology using a new rapid immunocytochemistry for evaluating surgical margin status after pulmonary sublobar resection

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Abstract

Objective

Sublobar resection is considered the gold standard for selected patients with pulmonary metastasis or who are compromised in some way. However, an unfavorable outcome after sublobar resection is local/margin recurrence. The aim of this study was to evaluate the clinical reliability of a new rapid-stapler lavage immunocytochemistry (ICC) technique for assessing margin malignancy. The method uses non-contact alternating current (AC) mixing to achieve more stable staining.

Methods

Twenty-one patients who underwent sublobar resection, including 16 wedge resections, for pulmonary metastasis or lung cancer in a compromised host between September 2016 and December 2017 were retrospectively reviewed. All margin specimens were intraoperatively evaluated with HE staining of frozen sections and stapler lavage cytology using Papanicolaou staining and rapid-ICC.

Results

Rapid-stapler lavage ICC can be used to diagnose surgically safe margins within 20 min during sublobar resections. Although in all cases margins were diagnosed as cancer free based on HE staining of frozen sections, two of four patients diagnosed with malignant-positive margins based on rapid ICC experienced local/margin recurrence.

Conclusions

Rapid-stapler lavage ICC with AC mixing could potentially serve as a clinical tool for prompt determination of margin malignant status after pulmonary sublobar resection.

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Acknowledgements

We thank Professor Shinya Tanaka of the Department of Cancer Pathology, Hokkaido University, who provided advice on the principles of AC electric field mixing.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan

    Nobuyasu Kurihara, Kazuhiro Imai, Shinogu Takashima & Yoshihiro Minamiya

  2. Department of Pathology, Akita University Graduate School of Medicine, Akita, Japan

    Hiroshi Nanjo, Yuko Hiroshima & Satoru Ito

  3. Department of Health Environmental Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan

    Kyoko Nomura

  4. Department of Chest Surgery, Iwate Medical University, Yahaba, Japan

    Hajime Saito

Authors
  1. Nobuyasu Kurihara
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  2. Kazuhiro Imai
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  3. Shinogu Takashima
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  4. Hiroshi Nanjo
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  9. Yoshihiro Minamiya
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Correspondence to Kazuhiro Imai.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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IRB approval was obtained.

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Not needed. IRB Protocol No. 2679 allows collection of tissue and medical record with consent or waiver of consent when no personalized health information is required, as was the case in this study.

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Kurihara, N., Imai, K., Takashima, S. et al. Stapler-lavage cytology using a new rapid immunocytochemistry for evaluating surgical margin status after pulmonary sublobar resection. Gen Thorac Cardiovasc Surg 70, 359–365 (2022). https://doi.org/10.1007/s11748-021-01733-y

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  • DOI: https://doi.org/10.1007/s11748-021-01733-y

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