Abstract：
BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a rare skin tumor. There is no standard recommendation for its surgical management. The currently used histological analysis are HES (hematoxylin eosin saffron) staining and immunohistochemistry for CD34 expression in particular cases. Fluorescent in situ hybridization (FISH) technique is only used to qualify the DFSP as translocated or non-translocated and is not used as a diagnostic method. The aim of our study was to determine by FISH (as a diagnostic method) whether cancerous cells that could not be identified through HES staining±immunohistochemistry were present at the two-centimeter margins that were found to be tumor-free.
METHODS: Samples from patients who underwent surgery between 2010 and 2018 were collected. Intralesional and peripheral (at 2cm margins) paraffin slides were included. An average of 7.4 slides per specimen was analyzed. Firstly, the preselected slides were reread by a senior pathologist to confirm the absence of microscopic findings of DFSP at 2cm margins. Secondly a FISH analysis was used as a quantitative diagnostic approach, in order to find the t(17;22) translocation.
RESULTS: Among the seven specimens that included 2cm margins, two samples presented one or more translocations, which were not visible in standard morphology assessments at two centimeters tumor-free margins.
CONCLUSIONS: FISH analysis can have a new role in defining tumor-free margins. This would reduce the incidence of disease recurrence after resection and improve the post-operative complementary care.
METHODS: Samples from patients who underwent surgery between 2010 and 2018 were collected. Intralesional and peripheral (at 2cm margins) paraffin slides were included. An average of 7.4 slides per specimen was analyzed. Firstly, the preselected slides were reread by a senior pathologist to confirm the absence of microscopic findings of DFSP at 2cm margins. Secondly a FISH analysis was used as a quantitative diagnostic approach, in order to find the t(17;22) translocation.
RESULTS: Among the seven specimens that included 2cm margins, two samples presented one or more translocations, which were not visible in standard morphology assessments at two centimeters tumor-free margins.
CONCLUSIONS: FISH analysis can have a new role in defining tumor-free margins. This would reduce the incidence of disease recurrence after resection and improve the post-operative complementary care.
摘要：
背景：隆突性皮肤纤维肉瘤（DFSP）是一种罕见的皮肤肿瘤。没有关于其手术管理的标准建议。目前使用的组织学分析是HES(苏木精伊红藏红花)染色和在特定情况下CD34表达的免疫组织化学。荧光原位杂交（FISH）技术仅用于将DFSP鉴定为易位或非易位，而不用作诊断方法。我们研究的目的是通过FISH（作为诊断方法）确定无法通过HES染色±免疫组织化学识别的癌细胞是否存在于发现无瘤的两厘米边缘。
方法：收集2010年至2018年接受手术的患者的样本。包括病灶内和外周(在2cm边缘)石蜡载玻片。分析每个样本平均7.4个载玻片。首先,由资深病理学家重读预选的载玻片,以确认在2厘米边缘没有观察到DFSP.其次，FISH分析被用作定量诊断方法，以找到t(17;22)易位。
结果：在包含2厘米边缘的七个标本中，两个样本呈现一个或多个易位，在2厘米无瘤边缘的标准形态学评估中不可见。
结论：FISH分析在确定无瘤边缘方面具有新的作用。这将减少切除术后疾病复发的发生率，并改善术后辅助护理。
方法：收集2010年至2018年接受手术的患者的样本。包括病灶内和外周(在2cm边缘)石蜡载玻片。分析每个样本平均7.4个载玻片。首先,由资深病理学家重读预选的载玻片,以确认在2厘米边缘没有观察到DFSP.其次，FISH分析被用作定量诊断方法，以找到t(17;22)易位。
结果：在包含2厘米边缘的七个标本中，两个样本呈现一个或多个易位，在2厘米无瘤边缘的标准形态学评估中不可见。
结论：FISH分析在确定无瘤边缘方面具有新的作用。这将减少切除术后疾病复发的发生率，并改善术后辅助护理。
