术中冰冻切片对早期宫颈癌腹部气管根治术诊断的准确性。

IF 3.7 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Risa Matsuda, Hiroshi Nishio, Akihisa Ueno, Tomoya Matsui, Takashi Iwata, Hajime Okita, Wataru Yamagami
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引用次数: 0

摘要

目的:术中冰冻切片检查是确定早期宫颈癌根治性腹腔气管切除术(RAT)肿瘤安全性的关键。本研究评估了我院RAT期间冷冻切片的诊断准确性。方法:回顾性分析2002年至2021年间接受国际妇产科联合会2008期IA1-IB1(肿瘤大小≤2cm)宫颈癌治疗的患者。在进行RAT时,常规对子宫手术缘和大面积肿大的淋巴结进行冷冻切片分析,证实为阴性。我们回顾了医疗记录,将冷冻切片诊断与最终病理进行比较。结果:326例原计划行RAT的患者中,298例(91.4%)行RAT, 28例(8.6%)转为根治性子宫切除术。组织学类型为鳞状细胞癌251例(77.0%),腺癌67例(20.6%)。361例手术切缘冰冻切片中,发现4例假阴性。差异是由于冷冻伪影,冷冻切片的染色质量,以及冷冻和石蜡包埋切片在横截面上的细微差异。术中淋巴结活检446例,假阴性1例。冰冻切片检查对手术缘的敏感性为93.5%(58/62),对淋巴结的敏感性为94.1%(16/17)。326例计划行RAT手术的患者系统性淋巴结切除术标本中有21例(6.4%)发现淋巴结转移,术中有10例(47.6%)发现淋巴结转移。未行淋巴结活检的患者中有7/112(6.3%)发现淋巴结转移。结论:RAT期间的冰冻切片检查提供了满意的诊断效果,尽管对大面积肿大的淋巴结进行活检是一种不可靠的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic accuracy of intraoperative frozen section at radical abdominal trachelectomy for early-stage cervical cancer.

Objective: Intraoperative frozen section examination is crucial for confirming the oncological safety of radical abdominal trachelectomy (RAT) for early-stage cervical cancer. This study evaluated the diagnostic accuracy of frozen section during RAT at our institution.

Methods: We retrospectively identified patients with International Federation of Gynecology and Obstetrics 2008 stage IA1-IB1 (tumor size ≤2 cm) cervical cancer treated between 2002 and 2021. In performing RAT, frozen section analysis was routinely performed on uterine surgical margins and grossly enlarged lymph nodes, and was confirmed to be negative. Medical records were reviewed to compare the frozen section diagnoses with the final pathology.

Results: Among the 326 patients initially planned to undergo RAT, 298 (91.4%) underwent RAT, while 28 (8.6%) were converted to radical hysterectomy. The histological types were squamous cell carcinoma in 251 (77.0%) patients and adenocarcinoma in 67 (20.6%). Of 361 frozen section for surgical margins, 4 false negatives were identified. Discrepancies were due to freezing artifacts, staining quality on frozen sections, and slight differences in cross-sections between frozen and paraffin-embedded sections. Among 446 intraoperative lymph-node biopsies, one false-negative was recorded. Sensitivities of frozen section examination were 93.5% (58/62) for surgical margins and 94.1% (16/17) for lymph nodes. Lymph-node metastases were identified in systematic lymphadenectomy specimens of 21/326 (6.4%) patients planned to undergo RAT, with 10/21 (47.6%) detected intraoperatively. Lymph-node metastases were found in 7/112 (6.3%) patients without lymph-node biopsy.

Conclusion: Frozen section examination during RAT provides satisfactory diagnostic performance, although biopsy of grossly enlarged lymph nodes is an unreliable method.

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来源期刊
Journal of Gynecologic Oncology
Journal of Gynecologic Oncology ONCOLOGY-OBSTETRICS & GYNECOLOGY
CiteScore
6.00
自引率
2.60%
发文量
84
审稿时长
>12 weeks
期刊介绍: The Journal of Gynecologic Oncology (JGO) is an official publication of the Asian Society of Gynecologic Oncology. Abbreviated title is ''J Gynecol Oncol''. It was launched in 1990. The JGO''s aim is to publish the highest quality manuscripts dedicated to the advancement of care of the patients with gynecologic cancer. It is an international peer-reviewed periodical journal that is published bimonthly (January, March, May, July, September, and November). Supplement numbers are at times published. The journal publishes editorials, original and review articles, correspondence, book review, etc.
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