Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan.
Department of Pathology, Kanazawa University School of Medicine, Kanazawa, Japan.
Int J Clin Oncol. 2021 Mar;26(3):613-619. doi: 10.1007/s10147-020-01836-1. Epub 2020 Nov 23.
A histological diagnosis obtained from an intraoperative frozen section (FS) during biopsy confirms the adequacy of tumor tissue in the specimen. However, some cases show a discrepancy among the intraoperative FS diagnosis, permanent section (PS) diagnosis of the biopsy specimen, and the final diagnosis of the excised tumor specimen. In this study, we retrospectively investigated the diagnostic accuracy of the FS and PS for different types of bone tumors.
This study included 377 patients with 411 bone tumors who underwent tumor excision after an open biopsy with intraoperative FS diagnosis. FS, PS, and final diagnoses of the patients were classified into benign tumors/tumor-like lesions, intermediate malignancies, and malignant tumors. To assess diagnostic accuracy, the histological grades in FS and PS diagnoses were compared with those in the final diagnoses.
The overall diagnostic accuracies of FS and PS were 93% and 97%, respectively. The accuracy of FS and PS for histological grade was 84% and 93% for chondrogenic tumors, 90% and 96% for osteogenic tumors, 97% and 98% for osteoclastic giant cell-rich tumors, 100% and 100% for tumors of undefined neoplastic nature, and 95% and 99% for other bone tumors, respectively.
These data suggest that surgical planning based on PS diagnosis is recommended for chondrogenic and osteogenic tumors.
活检过程中的组织学诊断（术中冰冻切片，FS）可确认标本中肿瘤组织的充分性。然而，一些病例的术中 FS 诊断、活检标本的永久切片（PS）诊断和切除肿瘤标本的最终诊断之间存在差异。本研究回顾性调查了 FS 和 PS 对不同类型骨肿瘤的诊断准确性。
本研究纳入了 377 例 411 个骨肿瘤患者，这些患者在开放性活检中进行了术中 FS 诊断，并随后进行了肿瘤切除。FS、PS 和患者的最终诊断被分为良性肿瘤/肿瘤样病变、中间恶性肿瘤和恶性肿瘤。为评估诊断准确性，FS 和 PS 中的组织学分级与最终诊断中的分级进行了比较。
FS 和 PS 的总体诊断准确率分别为 93%和 97%。FS 和 PS 对软骨源性肿瘤的组织学分级的准确率分别为 84%和 93%，对成骨性肿瘤的准确率分别为 90%和 96%，对破骨细胞丰富性巨细胞瘤的准确率分别为 97%和 98%，对性质不明的肿瘤的准确率分别为 100%和 100%，对其他骨肿瘤的准确率分别为 95%和 99%。
这些数据表明，基于 PS 诊断的手术计划推荐用于软骨源性和成骨性肿瘤。
