Karataşlı Volkan, Çakır İlker, Şahin Hilal, Ayaz Duygu, Sancı Muzaffer
Department of Gynecologic Oncology,University of Health Sciences Tepecik Education and Research Hospital, İzmir, Turkey.
Department of Radiology,University of Health Sciences Tepecik Education and Research Hospital, İzmir, Turkey.
Ginekol Pol. 2019;90(3):128-133. doi: 10.5603/GP.2019.0023.
To examine the performance of preoperative magnetic resonance imaging (MRI) and intraoperative frozen sectioning in the assessment of myometrial invasion during the early stages of endometrial cancer.
This retrospective study employed data from patients with endometrial cancer who were operated on between January 2013 and November 2018. Patients who underwent preoperative MRI and were of FIGO 2009 stage I were included in the study. Radiological staging and intraoperative staging by frozen sectioning were carried out. The data were analyzed to assess agreement of the overall results concerning myometrial invasion.
In total, 222 patients were enrolled. Their mean age was 58.3 ± 8.5 years. The accuracy of MRI for the detection of myometrial invasion was 88.7% and its sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 91.6%, 82.1%, 92.2%, and 80.9%, respectively, with a kappa coefficient of 0.734 (95% confidence interval [CI], 0.684-0.784; p < 0.001). The accuracy of intraoperative frozen sectioning was 94.4%, and its sensitivity, specificity, PPV, and NPV were 97.7%, 85.7%, 94.7%, and 93.4%, respectively, with a kappa coefficient of 0.856 (95% CI, 0.812-0.900; p < 0.001). No significant difference in accuracy was observed between MRI and frozen sectioning (p = 0.057). MRI and frozen sectioning were sensitive for the detection of myometrial invasion, according to receiver operating curve analyses (areas under the curve, 0.869 and 0.917, respectively; p < 0.001).
The assessment of myometrial invasion by preoperative MRI and intraoperative frozen sectioning during the early stages of endometrial carcinoma was highly accurate.
探讨术前磁共振成像（MRI）和术中冰冻切片在评估子宫内膜癌早期肌层浸润中的表现。
这项回顾性研究采用了2013年1月至2018年11月期间接受手术的子宫内膜癌患者的数据。纳入研究的患者为接受了术前MRI且为2009年FIGO I期的患者。进行了放射学分期和术中冰冻切片分期。对数据进行分析以评估关于肌层浸润的总体结果的一致性。
总共纳入了222例患者。他们的平均年龄为58.3±8.5岁。MRI检测肌层浸润的准确性为88.7%，其敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为91.6%、82.1%、92.2%和80.9%，kappa系数为0.734（95%置信区间[CI]，0.684 - 0.784；p < 0.001）。术中冰冻切片的准确性为94.4%，其敏感性、特异性、PPV和NPV分别为97.7%、85.7%、94.7%和93.4%，kappa系数为0.856（95%CI，0.812 - 0.900；p < 0.001）。MRI和冰冻切片在准确性方面未观察到显著差异（p = 0.057）。根据受试者工作特征曲线分析，MRI和冰冻切片对肌层浸润的检测均敏感（曲线下面积分别为0.869和0.917；p < 0.001）。
术前MRI和术中冰冻切片在评估子宫内膜癌早期肌层浸润方面具有高度准确性。
