Evaluation of the role of intraoperative frozen section and magnetic resonance imaging in endometrial cancer.
Evaluation of the role of intraoperative frozen section and magnetic resonance imaging in endometrial cancer.
复制标题
术中冰冻切片和磁共振成像在子宫内膜癌中的作用评价。
DOI：
10.1002/ijgo.14389
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Aoki D
中科院分区：
文献类型：
--
作者：
Ooka R;Nanki Y;Yamagami W;Kawaida M;Nagai S;Hirano T;Sakai K;Makabe T;Chiyoda T;Kobayashi Y;Kataoka F;Aoki D
目的评价子宫内膜癌术前活检及磁共振成像（MRI）与术中冷冻切片的准确性。方法回顾性研究纳入2014年至2018年在我院行子宫内膜癌术中冷冻切断术的264例患者。诊断依据组织学类型、分级和子宫肌层浸润。计算术前和术中冷冻诊断与最终病理诊断的符合率、敏感性和特异性。结果术前、术中诊断对组织学分型、分级的判定差异无统计学意义（P= 0.152）。术中诊断对3级及其他类型子宫内膜样癌敏感性较高，对1级子宫内膜样癌特异性较高。对于肌层浸润，术中诊断符合率明显高于术前MRI （P< 0.01）。术中诊断有肌层浸润和无肌层浸润的患者分别具有较高的敏感性和特异性。结论术中诊断与最终诊断的一致性较高，尤其是在子宫内膜侵犯方面，提示术中冰冻切片是一个很好的手术决策指标。
ObjectiveTo evaluate the accuracy of preoperative endometrial biopsy and magnetic resonance imaging (MRI) of endometrial cancer compared with that of intraoperative frozen section.MethodsThis retrospective study included 264 patients who underwent surgery with intraoperative frozen section for endometrial cancer at our institution between 2014 and 2018. Diagnosis was determined by histologic type, grade, and myometrial invasion. Concordance rate, sensitivity, and specificity of preoperative diagnosis and intraoperative frozen diagnosis were calculated, in comparison to the final pathologic diagnosis.ResultsPreoperative and intraoperative diagnoses showed no statistically significant difference in determining histologic type and grade (P= 0.152). Intraoperative diagnosis showed higher sensitivity for endometrioid carcinoma grade 3 and other types, and higher specificity for grade 1. For myometrial invasion, intraoperative diagnosis showed significantly higher concordance rate than preoperative MRI findings (P< 0.01). Intraoperative diagnosis showed higher sensitivity and specificity in patients with and without myometrial invasion, respectively.ConclusionHigher agreement between intraoperative and final diagnoses, especially in myometrial invasion, suggests that intraoperative frozen section is a good indicator for appropriate surgical procedure decision making.