影响乳腺癌术中冰冻结果的因素分析

目的 探讨影响乳腺癌术中冰冻结果诊断准确性的因素,提高乳腺癌的诊断准确率,降低误诊率.方法 回顾性分析成都医学院第一附属医院于2015年1月至2017年1月收治的96例乳腺癌患者的临床资料,通过手术中冰冻切片技术以及术后石蜡病理对乳腺癌组织进行肿瘤病理分级,比较其一致性并分析影响因素.结果 组织学大小≤3 cm肿块中,符合率为84.42%(65/77);组织学大小>3 cm的肿块符合率为94.74%(18/19),二者比较,差异有统计学意义(P<0.05);随着组织学级别的升高,乳腺冰冻切片及术后病理学分级的符合率升高;术中冰冻诊断乳腺癌组织学级别及组织学大小的准确性并不高,其影响因素是绝经后出现乳腺肿块、X线钼靶显示多发钙化点减少,组间比较差异有统计学意义(P<0.05).结论 术中冰冻切片诊断乳腺癌存在一定局限性,诊断准确性受到较多复杂因素影响,在临床诊断工作中需综合考虑,提高诊断准确率,降低误诊率,为乳腺癌患者选择临床治疗方案提供参考依据.

Analysis of Factors Affecting the Results of Frozen Section Examination in Breast Cancer

Objective To investigate the factors affecting the diagnostic accuracy of the frozen section examination in breast cancer so as to improve the diagnostic accuracy of breast cancer and reduce the misdiagnosis rate.Methods The clinical data of the 96 patients with breast cancer treated in The First Affiliated Hospital of Chengdu Medical College from January of 2015 to January of 2017 were analyzed retrospectively.The pathologic grading of the breast cancer tissues was made according to the examination results of the intraoperative frozen section and the postoperative paraffin section respectively.Then the consistency of the pathologic grading results was examined and the influencing factors were analyzed.Results The consistency rate was 84.42% (65/77) in the lumps with the histological size of no more than 3cm and that was 94.74% (18/19) in the lumps with the histological size of more than 3cm, and there were significant differences between the lumps with different histological sizes (P<0.05).The higher histological grades showed higher consistency between the examination results of the intraoperative frozen section and the postoperative paraffin section.The accuracy of the histological grades and sizes was not high in the examination of the intraoperative frozen section and the influencing factors involved the postmenopausal breast mass and the decreased multiple calcification showed by X-ray mammography, and there were significant differences between the two groups (P<0.05).Conclusion The examination of the intraoperative frozen section has some limitations in the diagnosis of breast cancer and its diagnostic accuracy is affected by a variety of complex factors, so the comprehensive consideration should be taken in the clinical diagnosis of breast cancer in order to improve the diagnostic accuracy, reduce the misdiagnosis rate and provide a reference for the selection of the clinical treatment program.