Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Int J Gynecol Cancer. 2011 Oct;21(7):1180-4. doi: 10.1097/IGC.0b013e318221eb92.
The objective of this study was to assess the value of intraoperative frozen section (IFS) diagnosis for myometrial invasion and histology of endometrial cancer using the revised International Federation of Gynecology and Obstetrics (FIGO) staging system.
The medical records of 303 patients with endometrial cancer who underwent surgery with intraoperative diagnosis at the Osaka University Hospital between January 1999 and December 2008 were reviewed. Intraoperative frozen section diagnosis was retrospectively analyzed for the accuracy rates of myometrial invasion and histology compared with the final diagnosis and with preoperative prediction by magnetic resonance imaging (MRI) and endometrial curettage.
When using the previous FIGO staging system, the accuracy rate of IFS for the diagnosis of myometrial invasion was 77%, whereas the accuracy rate of preoperative prediction by MRI was 54%. However, using the newly revised FIGO staging system for myometrial invasion, the accuracy rate of IFS was 87% and the preoperative prediction by MRI was 82%. The accuracy rate of IFS for the diagnosis of histology was 71%, whereas the accuracy rate of preoperative prediction by endometrial curettage was 68%.
Although under the previous FIGO staging system IFS diagnosis was significantly more accurate than preoperative prediction by MRI, when using the newly revised FIGO staging system, there are no significant differences between the values of preoperative and intraoperative diagnoses. The accuracy of IFS, however, trends to be slightly better than the preoperative procedures of MRI and endometrial surface biopsy. Thus, IFS diagnosis is still useful for directing primary operative management.
本研究旨在评估使用修订后的国际妇产科联合会（FIGO）分期系统，术中冷冻切片（IFS）诊断对子宫内膜癌肌层浸润和组织学的价值。
回顾了 1999 年 1 月至 2008 年 12 月在大阪大学医院接受手术并进行术中诊断的 303 例子宫内膜癌患者的病历。回顾性分析了术中冷冻切片诊断在肌层浸润和组织学方面与最终诊断和术前磁共振成像（MRI）及子宫内膜刮宫术预测的准确性。
当使用之前的 FIGO 分期系统时，IFS 对肌层浸润的诊断准确率为 77%，而 MRI 术前预测的准确率为 54%。然而，使用新修订的 FIGO 分期系统进行肌层浸润诊断时，IFS 的准确率为 87%，MRI 的术前预测准确率为 82%。IFS 对组织学诊断的准确率为 71%，而子宫内膜刮宫术的术前预测准确率为 68%。
虽然在之前的 FIGO 分期系统下，IFS 诊断明显优于 MRI 术前预测，但在使用新修订的 FIGO 分期系统时，术前和术中诊断的价值没有显著差异。然而，IFS 的准确性趋势略优于 MRI 和子宫内膜表面活检的术前检查。因此，IFS 诊断仍然有助于指导初次手术治疗。
