Shao Hua, Wang Na, Liu Guoyan
Clinical Psychology Department, Tianjin Medical University General Hospital, Tianjin, People's Republic of China.
Gynecology and Obstetrics Department, Tianjin Haihe Hospital, Tianjin, People's Republic of China.
Int J Womens Health. 2024 May 17;16:853-863. doi: 10.2147/IJWH.S458138. eCollection 2024.
To investigate the accuracy of intraoperative frozen section (FS) diagnosis for predicting the permanent section (PS) diagnosis of mucinous ovarian tumors and evaluate the factors affecting the diagnostic discordance.
This retrospective cohort study was performed in Tianjin Medical University General Hospital. All women who underwent ovarian surgery with FS between January 2011 and December 2022 were identified, and those with a diagnosis of mucinous ovarian tumor (MOT) by FS or PS were reviewed. Clinical and pathologic data were extracted.
A total of 180 women were included, of which 141 (78.33%) had diagnostic concordance between FS and PS, yielding a sensitivity of 83.43% and a positive predictive value (PPV) of 92.76%. Under- and over-diagnosis occurred in 28 cases (15.56%) and 11 cases (6.11%). Tumor size > 13cm (OR 3.79, 95% CI 1.12-12.73) was an independent risk factor for under-diagnosis, and tumor size ≤ 13cm (OR 16.78, 95% CI 0.01-0.49), laparoscopic surgery (OR 0.14, 95% CI 0.02-0.92), the combination of other tumor components (including serous, Brenner tumor, and chocolate cyst; OR 7.00, 95% CI 1.19-41.12) were independently associated with over-diagnosis. The Kaplan-Meier survival curves and the Log rank test showed no significant difference between misdiagnosed and accurately diagnosed patients (all P > 0.05).
Intraoperative frozen pathology of MOT is problematic for under- and over-diagnosis. The incorrect diagnosis of FS was related to determining the extent of surgery but had no impact on the patients' long-term recurrence and survival outcomes. In future clinical practice, surgeons need to obtain material accurately and enhance communication with pathologists during the operation to improve the accuracy of FS diagnosis.
探讨术中冰冻切片（FS）诊断对预测黏液性卵巢肿瘤永久切片（PS）诊断的准确性，并评估影响诊断不一致的因素。
本回顾性队列研究在天津医科大学总医院进行。确定了2011年1月至2022年12月期间所有接受FS卵巢手术的女性，并对那些经FS或PS诊断为黏液性卵巢肿瘤（MOT）的患者进行了回顾。提取了临床和病理数据。
共纳入180名女性，其中141名（78.33%）FS与PS诊断一致，敏感性为83.43%，阳性预测值（PPV）为92.76%。漏诊和误诊分别发生在28例（15.56%）和11例（6.11%）。肿瘤大小>13cm（OR 3.79，95%CI 1.12 - 12.73）是漏诊的独立危险因素，肿瘤大小≤13cm（OR 16.78，95%CI 0.01 - 0.49）、腹腔镜手术（OR 0.
