Rojat-Habib M C, Cravello L, Bretelle F, Roger V, Liprandi A, de Burtel I, d'Ercole C, Pellissier J F, Blanc B
Service d'anatomie-pathologique et de neuropathologie, hôpital de la Timone, Marseille, France.
Gynecol Obstet Fertil. 2000 Jul-Aug;28(7-8):518-25.
To assess the usefulness of frozen sections (FS) on endocervical margin in surgical conization or loop electrosurgical specimens.
In a prospective study, 150 patients were treated from October 1995 to December 1997: 69 cases without FS, 81 cases with FS. CIN on frozen section resulted in an immediate additional resection.
In the group without FS, 13 patients had involved endocervical margin by high-grade CIN (18.8%). Frozen section was impossible in a conization specimen that was too short. FS revealed 64 normal glandular epitheliums, seven squamous metaplasias in which two lesions were under-evaluated (being in fact CIN on permanent sections), eight high-grade CIN followed by additional resection in six cases and two invasive carcinomas. Endocervical margin on additionals section were always free of disease. The rate of failure was 2.6% among 77 cases. This rate corresponded to two under-evaluations. Invasive carcinoma and CIN without additional resection were excluded because frozen section only allowed a peroperative diagnosis. The average height of the cone and the rate of complications were similar. Repeat surgery was necessary in nine cases in the group without frozen section, in which five showed residual lesions, absent in the other group.
The ultimate histological interpretation was never difficult after frozen section. This method permits reduction of cases with involved cone margin and residual lesions and, despite some limitations, it may be useful for surgical management.
评估冷冻切片（FS）在内宫颈切缘用于宫颈锥切术或环形电切术标本中的作用。
在一项前瞻性研究中，1995年10月至1997年12月期间对150例患者进行了治疗：69例未行冷冻切片，81例进行了冷冻切片。冷冻切片诊断为CIN的患者立即进行了额外切除。
在未行冷冻切片的组中，13例患者的内宫颈切缘被高级别CIN累及（18.8%）。对于过短的锥切标本无法进行冷冻切片。冷冻切片显示64例正常腺上皮，7例鳞状化生，其中2例病变评估不足（实际上在永久切片中为CIN），8例高级别CIN，其中6例随后进行了额外切除，2例浸润性癌。额外切片的内宫颈切缘均无病变。77例患者中的失败率为2.6%。该比率对应于2例评估不足。由于冷冻切片仅能进行术中诊断，因此排除了未进行额外切除的浸润性癌和CIN。锥切的平均高度和并发症发生率相似。未行冷冻切片的组中有9例需要再次手术，其中5例显示有残留病变，另一组中无残留病变。
冷冻切片后最终的组织学解释从未困难。该方法可减少锥切切缘累及和残留病变的病例，尽管存在一些局限性，但可能有助于手术管理。
