What is a cold biopsy (instant biopsy)?

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“What is a cold biopsy?” This is a question that many people are interested in right now. Let's learn about cold biopsy techniques through this article to gain more knowledge about biopsy techniques in determining whether a tumor is benign or malignant.

1. Definition of “What is a cold biopsy?”

Cold biopsy is a form of biopsy right during surgery, also known as "cold cut". Cryosurgery, immediate biopsy, or cryo-sectional biopsy are rapid histopathological tests, when the doctor does not know whether the tumor is benign or malignant.
During surgery, the surgeon will remove part or all of the tumor and transfer it to the pathology department. At the pathology department, the pathologist cuts the specimens on a cold cutter to make slides. Based on the specimen obtained, the surgeon can determine the benign or malignant tumor, histological type. The time to perform specimen dissection takes place within 10 - 15 minutes.
After receiving the results of the pathology department whether the tumor is benign or malignant, now the doctor performing the surgery makes the decision to remove the whole tumor, if this is a benign tumor or the doctor will have to Larger tumor resection, lymph node dissection, and treatment as cancer surgery. Thanks to the application of this technique, patients and surgeons benefit from: not having to wait for long results, especially saving time because they do not have to operate twice.

2. Principle and method of performing cold biopsy technique

When the tissue sample is cooled, the water in the tissue turns to ice and acts as a mediator that holds the shape (framework) of the tissue, so that the tissue becomes hard and can be cut. thin okay.
Method of performing the cryo-biopsy The main equipment used to perform this technique is a cryo-biopsy machine, which is essentially a slicer, so the inside of the sealed chamber is cooled to a low temperature. This slide cutter is a very precise tool, capable of cutting tissue into slices as thin as 1 micrometer. Slices of cold biopsy tissue will normally be cut at 5 to 10 micrometers.
Fresh tissue samples taken from the operating room will be placed in a mold, and then rapidly frozen to about -20 to -30 degrees Celsius. To freeze, the tissue will be dipped in a special gel commonly called is OCT Compound - a compound consisting of poly ethylene glycol and polyvinyl alcohol; This compound is known by various trade names and when frozen has a density similar to that of frozen tissue.
At sub-zero temperatures, most tissues will become solidified, making thin cutting easy. Each type of tissue will have a suitable negative temperature range for processing. For tissues rich in fat or lipids, the temperature should be lowered to -40 to -50 degrees Celsius.
After the tissue specimen has been cast in the OCT Compound, the tissue mass will be cut in a cold chamber using a machine system. Microscopically, the slides are then placed on a slide and stained (usually with hematoxylin and eosin by the HE method).
The sample preparation in cold biopsy is much faster than in traditional histology (approximately 10 - 15 minutes versus 16 hours). However, the quality of staining slides is often poorer and the time pressure is much greater.

3. Implementation steps and application of cold biopsy technique

3.1. Steps to perform Step 1: Receive specimens The surgeon accepts fresh specimens from the following sources: endoscopic press, needle biopsy, intraoperative biopsy fragments.
Step 2: Fixing the specimen The patient after being received will be mounted on the rack with a fast-cooling gel fixation. Then put the patient rack with the specimen into the cold chamber immediately to freeze the specimen quickly. Next, attach the frozen specimen holder to the cutting position.
Step 3: Cut the slide The technician cuts the specimen into slices at 5 to 10 micrometers and then coats the slide.
Step 4: Stain the slide The technician dyes the slide according to the HE staining method (Hematoxylin & Eosin).
Step 5: Read the slide The technician after attaching the slide to the slide, then transfer the slide to the pathologist for reading. In the case of an immediate intraoperative biopsy, the pathologist immediately informs the surgeon of the results for the next appropriate treatment of the patient.
Step 6: Handle the remaining specimen. 3.2. Application of cryopreservation technique Intraoperative diagnosis Confirmation of cross section in cancer surgery Diagnosis of metastatic status of cancer tumor right in surgery. Cold biopsy, immediate biopsy or cryo-sectional biopsy is a biopsy technique that helps to quickly determine whether a tumor is benign or malignant right at the time of surgery, so that the surgeon will make recommendations. appropriate treatment for the patient. The technique offers high accuracy in determining tumor properties and does not take much time to wait for results.
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