Department of Gynecologic Oncology, University of Texas-Houston Obstetrics and Gynecology/McGovern Medical School, Houston, Texas.
Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
J Minim Invasive Gynecol. 2019 Jan;26(1):87-93. doi: 10.1016/j.jmig.2018.04.005. Epub 2018 Apr 19.
To compare the accuracy of frozen section diagnosis of borderline ovarian tumors among 3 distinct types of hospital-academic hospital with gynecologic pathologists, academic hospital with nongynecologic pathologists, and community hospital with nongynecologic pathologists-and to determine if surgical staging alters patient care or outcomes for women with a frozen section diagnosis of borderline ovarian tumor.
Retrospective study (Canadian Task Force classification II-1).
Tertiary care, academic, and community hospitals.
Women with an intraoperative frozen section diagnosis of borderline ovarian tumor at 1 of 3 types of hospital from April 1998 through June 2016.
Comparison of final pathology with intraoperative frozen section diagnosis.
Two hundred twelve women met the inclusion criteria. The frozen section diagnosis of borderline ovarian tumor correlated with the final pathologic diagnosis in 192 of 212 cases (90.6%), and the rate of correlation did not differ among the 3 hospital types (p = .82). Seven tumors (3.3%) were downgraded to benign on final pathologic analysis and 13 (6.1%) upgraded to invasive carcinoma. The 3 hospital types did not differ with respect to the proportion of tumors upgraded to invasive carcinoma (p = .62). Mucinous (odds ratio, 7.1; 95% confidence interval, 2.1-23.7; p = .002) and endometrioid borderline ovarian tumors (odds ratio, 32.4; 95% confidence interval, 1.8-595.5; p = .02) were more likely than serous ovarian tumors to be upgraded to carcinoma. Only 88 patients (41.5%) underwent lymphadenectomy, and only 1 (1.1%) had invasive carcinoma in a lymph node.
A frozen section diagnosis of borderline ovarian tumor correlates with the final pathologic diagnosis in a variety of hospital types.
比较 3 种不同类型医院——学术型妇科医院、非妇科学术型医院和社区医院——的妇科病理学家、非妇科病理学家对交界性卵巢肿瘤的冰冻切片诊断准确率，并确定对冰冻切片诊断为交界性卵巢肿瘤的患者进行手术分期是否会改变其治疗方案或结局。
回顾性研究（加拿大任务组分类 II-1 级）。
三级保健、学术和社区医院。
1998 年 4 月至 2016 年 6 月期间，在 3 种不同类型医院中通过术中冰冻切片诊断为交界性卵巢肿瘤的女性。
比较最终病理与术中冰冻切片诊断的一致性。
212 名女性符合纳入标准。212 例患者中，192 例（90.6%）的冰冻切片诊断与最终病理诊断相符，3 种医院类型的相关性无差异（p = .82）。7 例（3.3%）肿瘤在最终病理分析中降级为良性，13 例（6.1%）升级为浸润性癌。3 种医院类型在升级为浸润性癌的肿瘤比例方面无差异（p = .62）。黏液性（优势比，7.1；95%置信区间，2.1-23.7；p = .002）和子宫内膜样交界性卵巢肿瘤（优势比，32.4；95%置信区间，1.8-595.5；p = .02）比浆液性卵巢肿瘤更有可能升级为癌。仅有 88 例患者（41.5%）行淋巴结切除术，仅有 1 例（1.1%）淋巴结有浸润性癌。
在多种医院类型中，冰冻切片诊断为交界性卵巢肿瘤与最终病理诊断相符。
