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术中冰冻切片在子宫内膜癌手术分期中的准确性。

Accuracy of intraoperative frozen section in surgical staging of endometrial cancer.

作者信息

Gokulu Sevki G, Ilhan Tolgay T, Ulger Gorkem, Yildizbakan Ali, Cevikoglu-Killi Murside, Turkmen Ayse

机构信息

Mersin University Faculty of Medicine, Department of Obstetrics and Gynecology, Mersin, Turkey.

Mersin University Faculty of Medicine, Department of Pathology / Internal Medicine, Mersin, Turkey.

出版信息

Heliyon. 2024 Oct 5;10(19):e39027. doi: 10.1016/j.heliyon.2024.e39027. eCollection 2024 Oct 15.

Abstract

OBJECTIVE

This study evaluates the role of frozen section (FS) in determining the extent of disease during surgery.

MATERIALS AND METHODS

This study retrospectively analyzed a cohort of patients diagnosed with endometrioid-type endometrial cancer between 2019 and 2022 who underwent surgical intervention. The frozen section (FS) results were compared with the final pathology reports, focusing on tumor grade, depth of myometrial invasion, cervical involvement, and tumor diameter.

RESULTS

The final analysis included 187 patients. The predictive accuracy of FS in determining PS results was 85.6 % for endometrioid histology, 95.7 % for grade 3 tumors, 90.2 % for depth of myometrial invasion, 89.7 % for cervical involvement, and 95.9 % for tumor diameter. Notably, 9.8 % of cases initially classified as grade 1 intraoperatively were upgraded with the final pathology. Similarly, 6.3 % of grade II cases were upgraded, while 60.4 % were downgraded.

CONCLUSION

Our study highlights the effectiveness of FS as a dependable tool for assessing endometrial carcinomas and guiding surgical staging decisions. By utilizing FS, the risk of unnecessary surgeries and associated morbidity in patients can be reduced.

摘要

目的

本研究评估冰冻切片(FS)在手术过程中确定疾病范围的作用。

材料与方法

本研究回顾性分析了2019年至2022年间诊断为子宫内膜样型子宫内膜癌并接受手术干预的一组患者。将冰冻切片(FS)结果与最终病理报告进行比较,重点关注肿瘤分级、肌层浸润深度、宫颈受累情况和肿瘤直径。

结果

最终分析纳入187例患者。FS在确定病理分期结果方面的预测准确率,子宫内膜样组织学为85.6%,3级肿瘤为95.7%,肌层浸润深度为90.2%,宫颈受累为89.7%,肿瘤直径为95.9%。值得注意的是,术中最初分类为1级的病例中有9.8%在最终病理检查时升级。同样,II级病例中有6.3%升级,而60.4%降级。

结论

我们的研究强调了FS作为评估子宫内膜癌和指导手术分期决策的可靠工具的有效性。通过使用FS,可以降低患者不必要手术的风险和相关发病率。

相似文献

本文引用的文献

1
Endometrial cancer.子宫内膜癌。
Nat Rev Dis Primers. 2021 Dec 9;7(1):88. doi: 10.1038/s41572-021-00324-8.
2
Cancer of the corpus uteri: 2021 update.子宫体癌:2021年更新
Int J Gynaecol Obstet. 2021 Oct;155 Suppl 1(Suppl 1):45-60. doi: 10.1002/ijgo.13866.
4
ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma.ESGO/ESTRO/ESP 子宫内膜癌管理指南。
Int J Gynecol Cancer. 2021 Jan;31(1):12-39. doi: 10.1136/ijgc-2020-002230. Epub 2020 Dec 18.
5
Endometrial Cancer.子宫内膜癌
N Engl J Med. 2020 Nov 19;383(21):2053-2064. doi: 10.1056/NEJMra1514010.

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