THE ACCURACY OF FROZEN SECTION DIAGNOSIS OF OVARIAN-TUMORS
THE ACCURACY OF FROZEN SECTION DIAGNOSIS OF OVARIAN-TUMORS
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DOI：
10.1016/0090-8258(91)90306-p
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发表时间：
1991-06-01
影响因子：
4.7
通讯作者：
FLEUREN, GJ
中科院分区：
文献类型：
--
作者：
TWAALFHOVEN, FCM;PETERS, AAW;FLEUREN, GJ
我们比较了我们研究所6年间所有卵巢肿瘤的冰冻切片检查与石蜡切片的最终诊断。在此期间，946例卵巢肿瘤标本被取出进行组织学检查，176例(18.6%)进行了冰冻切片检查。最终组织学诊断分为良性(55.1%)、交界性恶性(10.3%)和恶性(34.6%)。冰冻切片对恶性或交界性病变的敏感性为83.5%，对良性病变的特异性为92.8%。计算预测值和95%可信区间：恶性为100%(93-100%)，交界性为62%(32-86%)，良性为92%(85-96%)。诊断问题出现在粘液细胞型的大型交界性肿瘤。对12例假阴性诊断的分析表明，其中11例涉及抽样误差。唯一一例假阳性和12例假阴性冰冻切片诊断中有1例判断错误。结论：当外科医生和病理医生意识到冰冻切片诊断卵巢肿瘤的局限性时，围手术期组织学检查是值得的，可以防止妇科患者治疗不足和过度治疗。
We compared all frozen section examinations of ovarian tumors during a 6-year period in our institute with the final diagnosis from paraffin sections. In this period, 946 ovarian tumor specimens were removed for histologic assessment; 176 (18.6%) had frozen section examination. Final histological diagnosis was divided into benign (55.1%), borderline malignant (10.3%), and malignant (34.6%). Sensitivity of the frozen section method for malignant or borderline disease was 83.5% and specificity for a benign lesion, 92.8%. Predictive values and 95% confidence intervals were computed: 100% (93–100%) for malignancy, 62% (32–86%) for borderline malignancy, and 92% (85–96%) for a benign disease. Diagnostic problems occurred in large borderline tumors of mucinous cell type. Analysis of the 12 false negative diagnoses revealed that a sampling error was involved in 11 cases. A judgment error was made in the only false positive and in 1 out of 12 false negative frozen section diagnoses. It is concluded that when surgeons and pathologists are aware of the limitations of frozen section diagnosis of ovarian tumors, peroperative histologic examination can be worthwhile and prevent under- and overtreatment of gynecologic patients.