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Acetic Acid and Iodine Staining for Determining Malignancy in Solid Tumors
Maulina Indah Anugrah Putri1, Sonar Soni Panigoro1, Agnes Stephanie Harahap2
1Surgical Oncology Division, Department of Surgery, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
The multi-staining (MS) method using acetic acid and iodine offers a viable alternative for intraoperative surgical margin evaluation in solid tumors. This technique can help differentiate malignant from non-malignant tissues, especially where frozen section (FS) is unavailable.
Area of Science:
- Surgical Oncology
- Diagnostic Pathology
- Oncologic Imaging
Background:
- Surgical margin assessment is crucial for solid cancer prognosis.
- Frozen section (FS) is the current standard but is time-consuming and costly.
- There is a need for accessible intraoperative margin evaluation methods.
Purpose of the Study:
- To evaluate the efficacy of a multi-staining (MS) method using acetic acid and iodine for differentiating malignant from non-malignant solid tumors.
- To determine if MS can serve as a practical alternative to frozen section (FS) in intraoperative settings.
Main Methods:
- The study involved 150 patients undergoing solid tumor surgery.
- Specimens were stained using a combination of 10% acetic acid and iodine (MS method) or left unstained as control.
- Pathologists evaluated stained and unstained samples, blinded to the staining method.
Main Results:
- The MS method demonstrated an overall sensitivity of 82% and specificity of 63.5%.
- Subgroup analysis showed high sensitivity for breast (100%) and oral cavity (94.1%) tumors, and high specificity for thyroid nodules (83.3%).
- The MS method correctly identified malignant tissues and distinguished them from benign or normal tissues.
Conclusions:
- The multi-staining (MS) method is a potential alternative for intraoperative macroscopic surgical margin evaluation.
- This technique is particularly beneficial for resource-limited settings lacking frozen section (FS) facilities.
- MS provides a valuable tool for real-time assessment of surgical margins in solid tumors.
