Department of Pathology, Northwestern University, Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, Illinois, USA.
J Clin Pathol. 2014 Jul;67(7):562-5. doi: 10.1136/jclinpath-2014-202174. Epub 2014 Mar 14.
Frozen section (FS) consultation is generally an accurate diagnostic modality. At our institution, we are frequently asked to assess transurethral resection specimens (TURBT) at FS for muscularis propria (MP) invasion by carcinoma. This study documents our experience in evaluating cancer-containing TURBT specimens at FS for MP invasion.
32 TURBT sent for FS from 2008-2010 were identified. The FS and permanent section (PS) diagnoses were reviewed. Cases excluded from the calculation of test performance included: (1) cases without cancer on FS or PS slides, (2) FS diagnosis deferred, (3) cases without MP on FS and subsequent PS slides. Sensitivity (SEN), specificity (SPEC), positive predictive value (PPV), and negative predictive value (NPV) for identifying MP invasion at FS were calculated.
In 6 cases, no cancer was present in FS or PS slides (18%). The FS diagnosis was deferred on 3 cases (9%). In one case (3%) MP was not present in the FS or the subsequent PS slides. Of the remaining 22 cases, 2 false positive and 6 false negative diagnoses of MP invasion were identified. The test performance for FS assessment of MP invasion in TURB were SEN=33%, SPEC=84%, PPV=60%, and NPV=64%.
Identifying MP invasion on PS can be difficult, and our results suggest that this is more difficult at FS. Though this study is based on small numbers, our results point to the conclusion that examination of TURBT specimens for MP invasion is best done on PS.
冰冻切片（FS）检查通常是一种准确的诊断方式。在我们的机构中，我们经常被要求在 FS 评估经尿道膀胱肿瘤切除术（TURBT）标本中是否存在癌侵犯固有肌层（MP）。本研究记录了我们在 FS 评估含有癌症的 TURBT 标本中评估 MP 侵犯的经验。
从 2008 年至 2010 年，确定了 32 例送检 FS 的 TURBT。回顾 FS 和永久切片（PS）的诊断。排除在测试性能计算之外的病例包括：（1）FS 或 PS 切片上无癌症的病例，（2）FS 诊断推迟，（3）FS 上无 MP 且随后 PS 切片上也无 MP 的病例。计算 FS 识别 MP 侵犯的敏感性（SEN）、特异性（SPEC）、阳性预测值（PPV）和阴性预测值（NPV）。
在 6 例中，FS 或 PS 切片上均未发现癌症（18%）。3 例（9%）的 FS 诊断被推迟。在 1 例（3%）中，FS 或随后的 PS 切片上均未发现 MP。在剩余的 22 例中，发现 2 例假阳性和 6 例假阴性的 MP 侵犯诊断。FS 评估 TURBT 中 MP 侵犯的测试性能为 SEN=33%，SPEC=84%，PPV=60%，NPV=64%。
在 PS 上识别 MP 侵犯可能很困难，我们的结果表明在 FS 上更困难。尽管本研究基于少数病例，但结果表明，最好在 PS 上检查 TURBT 标本中是否存在 MP 侵犯。
