Study On The Improvement Of Diagnosis Accuracy Of Intraoperative Breast Disease By The Detection Of Frozen Sections Combined With Tissue Imprint Cell DNA Ploidy Analysis

Breast tumour is one of the most common female diseases. Themicroscopic morphology of frozen breast tissue is various, which broughthuge challenge for the intraoperative diagnosis, so how to improve theaccuracy of intraoperative diagnosis is significative to clinical treatment.This article explores a quick Feulgen staining method and analyzes thevalue of intraoperative tissue imprints cell DNA ploidy in breast diagnosisquickly frozen, and explores the relationship between DNA ploidy andclinicopathologic features and expression of Ki-67, providing a theoreticalbasis for the diagnosis of breast tumor, the operation scheme and theevaluation of prognosis.First of all, standard printed piece of adult healthy male SD rat livertissue was taken for quick Feulgen staining, and the best dyeingtemperature and time was got by setting the different temprature andhydrolysis time, which can provide accurate and standard experimentmethod for intraoperative DNA ploidy analysis. Intraoperative breastspecimens of230cases of Air Force General Hospital between February2012and February2014were selected, and230cases of breast specimenswere frozen section and tissue imprints of DNA ploidy analysis. The seniorpathologists were divided into two groups: one group consisted of twopathologists who diagnosed frozen sections in operation by double-blindmethod; the other group was made up of two other seinors who did frozensections combined with intraoperative DNA ploidy scan results to make acombined diagnosis, intraoperative diagnosis and postoperative paraffin diagnosis and then carried out comparative analysis. The expression ofKi-67of breast tissue was detected after operation, and the postoperativeclinical and pathological data collected.Based on the values of quick Feulgen staining IOD at differenttemperatures, under the condition of the60℃and the staining time was5min, DNA content(IOD) were at the maximum, and the dyeing resultswere very satisfactory. The dye of nucleus was deep, the structure clear,and background’s dye was lightish. So the above dyeing conditions wereconsidered as the experimental group Feulgen staining method. After101cases of intraoperative specimens of benign breast imprints were stainedwith Feulgen method,99cases had no>5C aneuploid cells, the result wasnegative, and2cases had>5C of aneuploid cells, the result positive.Among129cases of intraoperative specimens of benign breast imprintsafter Feulgen staining,114cases had>5C aneuploid cell, the result waspositive, and15cases had no>5C aneuploid cells, the result negative.>5C percentage mean and DI mean was not significantly different betweenquick Feulgen staining and conventional Feulgen staining (P>0.05). Of230cases of intraoperative frozen sections of breast specimens, the separatediagnostic accuracy was98.69%, the delay diagnosis was6.96%. Of frozensections combined with tissue imprint DNA ploidy analysis, the diagnosticaccuracy was99.57%, delay diagnosis1.74%. Diagnostic accuracy was notsignificantly different between combined diagnosis and frozen sections(P>0.05), while delay diagnosis rate was statistically significant (P<0.05).The sensitivity and negative predictive value of frozen sections was betterthan DNA ploidy analysis (P<0.05); the sensitivity and negative predictivevalue of frozen sections combined with tissue imprint DNA ploidy analysisdiagnostic were better than that of DNA ploidy analysis (P<0.05).Combined diagnosis of the indicators was better than that of frozen sections,but not statistically significant (P>0.05). In the histological grouping, theDI of only fibroadenomas and intraductal papilloma not mean statistically significant， among other groups>5C cell percentage mean and meancomparison DI were statistically significant (P<0.05). With increasingclassification of expression of antigen Ki-67, DNA content increases, andthe increase in DNA content was statistically significant (P<0.05). Basedon postoperative pathological data analysis, DNA content was significantlycorrelated with histological grade and lymph node metastasis (P<0.05), butthe DNA content was not significantly correlated with age and tumor size(P>0.05).Quick Feulgen staining method is fast, accurate, stable, and easy toautomation, it has the good dyeing effect, shorten the dyring time than theconventional Feulgen staining method. It is applicable to measure andanalyze the cell DNA content and its ploidy with image analysis system.For most breast masses, AICM-DNA and frozen section diagnosisconsistent, a good auxiliary detection method AICM-DNA can be used asintraoperative frozen section. Frozen sections combined with tissue printingcells DNA times can improve the accuracy of intraoperative frozen sectiondiagnosis of breast, the measurement results of objective, providingvaluable diagnostic evidence, with broad application prospects. DNAcontent is not related with the age and tumor size; DNA content is relatedwith the lymph node metastasis, histological grade and Ki-67. Higherhistological grade and Ki-67values are correlating with higher DNAcontent, suggesting a large degree of malignancy and poor prognosis.