The detection of single
tumor cells or
tumor cell clusters represents an important issue in intraoperative frozen section analysis. For example,
surgical margins may be evaluated in order to minimize the number of additional operations. Furthermore, intraoperative diagnosis of lymph node
micrometastasis (LNM) may help to define the area of appropriate
lymph node dissection. In addition to haematoxylin and
eosin (H&E)-stained sections, immunohistochemical detection of single
tumor cells or cell clusters may be helpful in this context. The aim of this study was to evaluate the clinical significance, reliability and sensitivity of intraoperative rapid immunostaining of frozen sections. Therefore, we compared the results of rapid immunohistochemical staining of frozen sections and
paraffin sections applying the EnVision and Histofine(R) detection systems. In a prospective immunohistochemical study,
paraffin and frozen sections of 20
gastric cancer specimens were analyzed.
Paraffin as well as frozen sections were stained immunohistochemically applying the EnVision and Histofine detection systems. As primary
antibodies, AE1/AE3 (anti-
cytokeratin), EMA (anti-MUC1) and B lymphocyte marker anti-CD20 were applied. The rapid immunostaining procedure was able to be completed within 10-13 min. Rapid immunohistochemical staining of frozen and
paraffin sections of the same
tumors resulted in comparable immunoreactivity. The rapid EnVision and Histofine procedures allowed immunostaining of frozen sections in less than 13 min. These methods can represent useful additional tools in routine surgical pathology and research, enabling a more accurate frozen section diagnosis compared to staining with H&E alone. Intraoperative rapid immunostaining can be a simple and useful technique to detect LNM.