手术中冰冻切片延迟诊断分析

目的探讨手术中冰冻切片与石蜡切片的符合率，分析冰冻切片延迟诊断的原因。方法回顾分析2005年1月1日-2008年11月30日术中冰冻切片诊断，对照术后石蜡切片诊断。结果术中冰冻切片诊断1128例，以卵巢、甲状腺和乳腺居多，冰冻确诊1103例（97．8％），延迟诊断19例（1．68％），假阴性6例（0．53％）。造成延迟和假阴性诊断的主要原因是取材局限和对部分病变认识不足。结论掌握正确的取材方法，提高切片质量，提高对良恶性肿瘤的认识及鉴别能力，必要时延迟诊断，才能提高诊断准确率，避免误诊。

Analysis of deferred diagnosis about intraoperative frozen section

Objective To investigate the concordance rate of intra-operative diagnosis with final diagnosis on permanent sections, and to analyze the reasons of deferrals for frozen section.Methods A retrospective study of all frozen section report was undertaken in our hospital from January 1st 2005 to November 30th 2008.Intra-operative diagnosis and its corresponding final diagnosis on permanent sections were reviewed.Results A total of 1128 cases were received. Ovary, thyroid and breast were among the most common tissues sent for frozen section diagnosis. The overall accuracy was 97.8% .19 cases were deferred to permanent sections （1.68%）, and 6 cases got false -negative intra-operative diagnosis（0.53% ）. The main causes for the discrepancies were limitation of sampling and recognition for certain lesions.Conclusion Carefully gross tissue sampling and improved diagnostic ability are essential to increase accuracy and avoid misdiagnosis. Deferral rates should be controlled within the range.