Accuracy of histological grades from intraoperative frozen-section diagnoses of soft-tissue tumors
Accuracy of histological grades from intraoperative frozen-section diagnoses of soft-tissue tumors
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DOI：
10.1007/s10147-020-01762-2
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发表时间：
2020-08-10
影响因子：
3.3
通讯作者：
Tsuchiya, Hiroyuki
中科院分区：
文献类型：
--
作者：
Miwa, Shinji;Yamamoto, Norio;Tsuchiya, Hiroyuki
背景：对于切除的肿瘤标本，活检诊断和最终诊断的组织学分级可能不同。方法回顾性分析软组织肿瘤冷冻切片和永久切片的组织学分级诊断准确性。冷冻切片、永久切片和最终诊断分为良性肿瘤/肿瘤样病变、中度恶性肿瘤或恶性肿瘤。通过比较切除标本的最终诊断来评估冷冻切片和永久切片的组织学分级的诊断准确性。结果冷冻切片和永久切片的组织学分级诊断准确率分别为95%（387/408）和97%（395/408）。在肿瘤类型中，脂肪细胞瘤冷冻切片和永久切片诊断组织学分级的准确率分别为84%和87%，纤维母细胞/肌纤维母细胞肿瘤的准确率分别为87%和91%，神经鞘肿瘤的准确率分别为99%和100%，纤维组织细胞肿瘤的准确率分别为98%和98%，分化不确定肿瘤的准确率分别为90%和98%，血管肿瘤的准确率为100%和100%，其他肿瘤的准确率分别为97%和98%。结论冷冻切片诊断的组织学分级对脂肪细胞瘤和成纤维细胞瘤/肌成纤维细胞瘤的诊断准确性较低。治疗应根据这些肿瘤的永久切片诊断和放射学表现来计划。
Background For excised tumor specimens, histological grades can differ between the biopsy diagnosis and the final diagnosis. Methods We retrospectively investigated the diagnostic accuracies of histological grades for frozen-section and permanent-section diagnoses from patients with soft-tissue tumors. Frozen-section, permanent-section, and final diagnoses were classified as benign tumors/tumor-like lesions, intermediate malignancies, or malignant tumors. Diagnostic accuracies of the histological grades from the frozen and permanent sections were evaluated by comparing the final diagnoses for the resected specimens. Results The diagnostic accuracies of the histological grades for the frozen- and permanent-section diagnoses were 95% (387/408 lesions) and 97% (395/408 lesions), respectively. Among the tumor types, the diagnostic accuracies of the histological grades for the frozen-section and permanent-section diagnoses were 84% and 87% for adipocytic tumors, 87% and 91% for fibroblastic/myofibroblastic tumors, 99% and 100% for nerve-sheath tumors, 98% and 98% for fibrohistiocytic tumors, 90% and 98% for tumors of uncertain differentiation, 100% and 100% for vascular tumors, and 97% and 98% for other tumors, respectively. Conclusions Histological grades from frozen-section diagnoses yielded low diagnostic accuracies in adipocytic and fibroblastic/myofibroblastic tumors. Treatment should be planned based on permanent-section diagnosis and radiological findings for these tumors.