Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Obstetrics and Gynecology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
J Gynecol Oncol. 2019 Nov;30(6):e95. doi: 10.3802/jgo.2019.30.e95.
To determine the accuracy of frozen section diagnosis and factors associated with final pathological diagnosis upgrade in patients with mucinous ovarian tumors.
This study included 1,032 patients with mucinous ovarian tumors who underwent frozen section diagnosis during surgery. Sensitivity, specificity, and diagnostic accuracy of frozen section diagnosis was calculated. Univariate and multivariate regression analyses were performed to determine factors associated with diagnosis upgrade in the final pathology report.
The sensitivity and specificity of frozen section diagnosis were 99.1% (95% confidence interval [CI]=98%-99.6%) and 82.2% (95% CI=77.9%-85.7%), respectively, for benign mucinous tumors; 74.6% (95% CI=69.1%-79.4%) and 96.7% (95% CI=95.2%-97.8%), respectively, for mucinous borderline ovarian tumors; and 72.5% (95% CI=62.9%-80.3%) and 98.8% (95% CI=97.9%-99.3%), respectively, for invasive mucinous carcinomas. The multivariate analysis revealed that mixed tumor histology (odds ratio [OR]=2.8; 95% CI=1.3-6.3; p=0.012), tumor size >12 cm (OR=2.5; 95% CI=1.5-4.3; p=0.001), multilocular tumor (OR=2.9; 95% CI=1.4-6.0; p=0.006), and presence of a solid component in the tumor (OR=3.1; 95% CI=1.8-5.1; p<0.001) were independent risk factors for final pathological diagnosis upgrade.
Mixed tumor histology, tumor size >12 cm, multilocular tumor, and presence of a solid component in the tumor were independent risk factors for final pathological diagnosis upgrade based on frozen section diagnosis.
确定冰冻切片诊断在黏液性卵巢肿瘤患者中的准确性，以及与最终病理诊断升级相关的因素。
本研究纳入了 1032 例在手术中接受冰冻切片诊断的黏液性卵巢肿瘤患者。计算了冰冻切片诊断的敏感性、特异性和诊断准确性。进行了单因素和多因素回归分析，以确定与最终病理报告中诊断升级相关的因素。
良性黏液性肿瘤的冰冻切片诊断敏感性和特异性分别为 99.1%（95%置信区间[CI] = 98%-99.6%）和 82.2%（95% CI = 77.9%-85.7%）；交界性黏液性卵巢肿瘤分别为 74.6%（95% CI = 69.1%-79.4%）和 96.7%（95% CI = 95.2%-97.8%）；浸润性黏液性癌分别为 72.5%（95% CI = 62.9%-80.3%）和 98.8%（95% CI = 97.9%-99.3%）。多因素分析显示，混合肿瘤组织学（比值比[OR] = 2.8；95%CI = 1.3-6.3；p=0.012）、肿瘤直径>12 cm（OR=2.5；95%CI = 1.5-4.3；p=0.001）、多房性肿瘤（OR=2.9；95%CI = 1.4-6.0；p=0.006）和肿瘤中存在实性成分（OR=3.1；95%CI = 1.8-5.1；p<0.001）是最终病理诊断升级的独立危险因素。
基于冰冻切片诊断，混合肿瘤组织学、肿瘤直径>12 cm、多房性肿瘤和肿瘤中存在实性成分是最终病理诊断升级的独立危险因素。
