快速冰冻病理检查在子宫内膜癌术中的指导价值

目的探讨术中冰冻对子宫内膜癌的诊断价值。方法回顾分析术中行快速冰冻检查子宫内膜癌患者的临床病理资料50例,对比术中冰冻切片与术后石蜡切片诊断组织学分级及肌层浸润深度的符合率,并分析影响其准确性的临床因素。结果术中冰冻结果与术后病理的组织学分级的总体符合率为68.0%,其中G1、G2、G3子宫内膜癌符合率分别为63.2%、66.7%、75.0%。肌层浸润深度的整体符合率为79.1%,浸润深度≥1/2肌层的符合率为82.4%,显著高于<1/2肌层的符合率76.9%,差异有统计学意义。结论术中冰冻诊断组织学分级的准确率不高,能较准确地诊断肌层浸润深度,尤其对于浸润深度≥1/2肌层的判断。因此,快速冰冻病理检查在子宫内膜癌手术中有一定的指导价值,可作为评估肌层浸润深度的常规检查。

The value of intraoperative frozen section in endometrial carcinoma

Objective To evaluate the diagnostic value of intraoperative frozen section in endometrial carcinoma.Methods The retrospective analysis was performed on fifty women diagnosed as endometrial cancer who were treated in our Hospital.All patients were performed intra-operative frozen section.The analysis about intra-operative frozen section was to evaluate its diagnostic accuracy in surgeries of endometrial carcinoma patients.Results The overall concordance rate in tumor grade was 68.0% between frozen section and permanent pathology.The concordance rate of G1,G2 and G3 differential tumor cell was respectively 63.2%,66.7% and 75.0%.The overall concordance rate of depth of myometrial invasion was 79.1%,especially in the cases whose myometrial invasion was more than the outer half of the uterus,the concordance rate was 82.4%,which was significantly higher than the concordance rate of depth of invasion with tumor confined to inner half of the uterus 76.9% respectively with significant difference.Conclusion Frozen section is more accurate in determining the myometrial invasion of endometrial carcinoma than the histological grading especially for the outer half of the uterus.Frozen section is not correlated with final pathology entirely.Under some guidance of intra-operative frozen section,it can be a routine examination to estimate myometrial invasion of endometrial carcinoma.