Accuracy of frozen section for the operative management of endometrial cancer
Accuracy of frozen section for the operative management of endometrial cancer
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DOI：
10.1111/j.1471-0528.2001.00196.x
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发表时间：
2001-08-01
期刊：
影响因子：
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通讯作者：
Nicklin, JL
中科院分区：
文献类型：
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作者：
Quinlivan, JA;Petersen, RW;Nicklin, JL
目的评价术中冷冻切片报告与最终组织病理学报告鉴别高危子宫疾病特征的准确性。设计回顾性研究。方法对1996年1月1日至1998年12月31日在昆士兰妇科癌症中心登记的460例子宫癌患者的资料进行回顾性分析。对260例子宫内膜腺癌患者进行术中冷冻切片。将冷冻切片病理与最终组织病理报告进行比较。使用一致性百分比和kappa统计来评估观察者间的信度。临床记录也被审查，以确定错误是否导致次优的病人护理。结果88.6%（预期61.5%,Kappa 0.70）和94.7%（预期53.8%,Kappa 0.89）的病例准确报告了肿瘤分级和肌层浸润深度。错误主要是由于对肿瘤分级的解释困难。结论在子宫内膜癌的情况下，冷冻切片能准确识别高危子宫疾病的特征，对指导初级手术治疗具有重要作用。
Objective To assess the accuracy of intra-operative frozen section reports at identifying the features of high risk uterine disease compared with final histopathology.Design Retrospective study.Methods The records, of 460 patients with uterine cancer registered with the Queensland Centre for Gynaecological Cancer between January 1, 1996 and December 31, 1998 were reviewed. Intra-operative frozen section was undertaken in 260 patients with endometrial adenocarcinoma. Frozen section pathology was compared with the final histopathology reports. Inter-observer reliability was assessed using percentage agreement and kappa statistics. Clinical notes were also reviewed to determine if errors resulted in sub-optimal patient care.Results Respectively, tumour grade and depth of myometrial invasion were accurately reported in 88.6% of cases (expected 61.5%, Kappa 0.70) and 94.7% (expected 53.8%, Kappa 0.89). Errors were predominantly attributable to difficulties with respect to the interpretation of tumour grade. The error resulted in the patient receiving sub-optimal surgical management in only I I cases (5.3%)Conclusion Frozen section is accurate at identifying the features of high risk uterine disease in the setting of endometrial cancer and can play an important role in directing primary operative management.