子宫内膜癌患者子宫肌层浸润冰冻切片检查中的诊断问题，特别强调伴有癌累及的深部子宫腺肌病的陷阱。

Diagnostic problems on frozen section examination of myometrial invasion in patients with endometrial carcinoma with special emphasis on the pitfalls of deep adenomyosis with carcinomatous involvement.

作者信息

Kir G, Kir M, Cetiner H, Karateke A, Gurbuz A

机构信息

Department of Pathology, Zeynep Kamil Maternity and Children's Hospital, Istanbul, Turkey.

出版信息

Eur J Gynaecol Oncol. 2004;25(2):211-4.

PMID:15032284

Abstract

Frozen-section and paraffin section diagnoses were compared in 55 patients with Stage I endometrial adenocarcinoma. In 44 patients (80%), a corresponding depth of myometrial invasion and in 54 (98%) patients the same tumor grade were found. Regarding the depth of myometrial invasion and histologic grade, sensitivity, specificity, positive and negative predictive values were 70%, 86%, 73%, 83% and 92%, 100%, 100%, 94%, respectively. Concerning myometrial invasion 9% false-positivity and 10% false-negativity rates were noted. The histopathologic characteristics of false-positive and false-negative patients are emphasized because carcinomatous involvement of deeply situated adenomyosis and advanced grade tumors are the main diagnostic pitfalls. It is important for pathologists to be able to identify carcinomatous involvement of adenomyosis and adjacent foci of minimal myometrial invasion during frozen-section examination which can prevent aggressive surgery.

摘要

对55例I期子宫内膜腺癌患者的冰冻切片诊断结果与石蜡切片诊断结果进行了比较。44例患者（80%）的肌层浸润深度相对应，54例患者（98%）的肿瘤分级相同。就肌层浸润深度和组织学分级而言，敏感性、特异性、阳性预测值和阴性预测值分别为70%、86%、73%、83%和92%、100%、100%、94%。关于肌层浸润，发现假阳性率为9%，假阴性率为10%。强调了假阳性和假阴性患者的组织病理学特征，因为深部子宫腺肌病的癌浸润和高级别肿瘤是主要的诊断陷阱。病理学家能够在冰冻切片检查中识别子宫腺肌病的癌浸润和肌层微浸润的相邻病灶非常重要，这可以避免激进的手术。