3436例卵巢肿瘤术中冰冻病理检查结果分析OACSTPCD
Analysis of intraoperative frozen section examination in 3436 ovarian tumors
目的:探讨卵巢肿瘤术中冰冻病理检查的准确性.方法:回顾分析2011 年1 月至2023 年3 月在南京大学医学院附属鼓楼医院妇科接受手术治疗,术中行冰冻病理检查,且常规病理检查诊断为卵巢四大肿瘤(包括上皮性肿瘤、生殖细胞肿瘤、性索间质肿瘤、转移性肿瘤)的患者的临床病理资料.评估术中冰冻病理检查诊断卵巢原发肿瘤良恶性的准确性,计算良性、交界性、恶性卵巢肿瘤术中冰冻病理检查的敏感性、特异性、阳性预测值、阴性预测值;评估术中冰冻病理检查鉴别卵巢原发恶性肿瘤组织学分型的准确性;评估术中冰冻病理检查对卵巢转移性肿瘤定性为转移的准确性.结果:(1)术中冰冻病理检查诊断卵巢原发肿瘤良恶性的总体准确率为93.58%,其中交界性黏液性肿瘤、黏液性癌、未成熟畸胎瘤、颗粒细胞瘤的诊断准确率分别为 70.16%、52.94%、46.15%、77.14%;卵巢良性、交界性、恶性肿瘤术中冰冻病理检查总体敏感性分别为 99.40%、80.95%、92.99%;总体特异性分别为 92.80%、98.38%、99.49%.(2)术中冰冻病理检查鉴别卵巢原发恶性肿瘤组织学分型的总体准确率为94.39%,其中无性细胞瘤、卵黄囊瘤的准确率较低,分别为61.11%、58.33%.(3)术中冰冻病理检查对卵巢转移性肿瘤定性为转移的准确率为53.78%,其中阑尾来源的准确率极低,为22.22%.结论:术中冰冻病理检查对卵巢肿瘤诊断的总体准确性高,但在交界性黏液性肿瘤、黏液性癌、未成熟畸胎瘤、颗粒细胞瘤的良恶性判断,无性细胞瘤和卵黄囊瘤的组织学分型及转移性肿瘤定性转移方面准确性差.
Objective:To investigate the accuracy of intraoperative frozen section exam-ination in ovarian tumors.Methods:The clinicopathological data of patients who underwent sur-gical treatment with intraoperative frozen section and were diagnosed as ovarian tumors by per-manent section at Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2011 to March 2023 were analyzed.The accuracy of intraoperative frozen section exami-nation in the diagnosis of malignant potential of primary ovarian tumors was evaluated.The sen-sitivity,specificity,positive predictive value and negative predictive value of intraoperative fro-zen section examination in benign,borderline and malignant ovarian tumors were calculated re-spectively.The accuracy of intraoperative frozen section examination in differentiating histologi-cal types of primary ovarian malignancies was evaluated.The accuracy of intraoperative frozen section examination in identifying the primary or secondary nature of ovarian metastatic tumor was evaluated.Results:(1)The overall accuracy rate of frozen section examination in the diag-nosis of malignant potential of primary ovarian tumors was 93.58%,and the accuracy rates of borderline mucinous tumor,mucinous carcinoma,immature teratoma and granulosa cell tumor were 70.16%,52.94%,46.15%and 77.14%,respectively.The overall sensitivity of intraop-erative frozen section examination for benign,borderline and malignant ovarian tumors were 99.40%,80.95%and 92.99%,respectively.The overall specificity were 92.80%,98.38%and 99.49%,respectively.(2)The overall accuracy rate of intraoperative frozen section exami-nation in differentiating histological types of primary ovarian malignancies was 94.39%,and the accuracy rates of dysgerminoma and yolk sac tumor were 61.11%and 58.33%,respectively.(3)The accuracy rate of intraoperative frozen section examination in identifying the primary or secondary nature of ovarian metastatic tumor was 53.78%,and the accuracy of tumors metasta-sized from the appendix was very low(22.22%).Conclusion:The overall accuracy of intraop-erative frozen section examination for ovarian tumors was high.However,the accuracy rate in the diagnosis of the malignant potential of borderline mucinous tumor,mucinous carcinoma,imma-ture teratoma,granulosa cell tumor was low,as well as in differentiating the histological types of dysgerminoma and yolk sac tumor and identifying the primary or secondary nature of metastatic tumor.
刘柳柳;徐晓峰;李志文;郑金榆;周怀君
南京大学医学院附属鼓楼医院妇科,南京 210008南京大学医学院附属鼓楼医院病理科,南京 210008
临床医学
卵巢肿瘤术中冰冻病理检查常规病理检查准确性良恶性质组织学分型转移性肿瘤
Ovarian tumorIntraoperative frozen section examinationPermanent sec-tion examinationAccuracyMalignant potentialHistological typesMetastatic tumor
《现代妇产科进展》 2024 (009)
641-647 / 7
江苏省自然科学青年基金(No:BK20210024);江苏省卫健委医学科研面上项目(No:H2019012)
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