乳腺上皮性病变745例冷冻切片误诊与延迟诊断分析  

Misdiognosis and delayed diagnosis of breast epithelial lesions by frozen sections:an analysis of 745 cases

作　　者：宦大为[1] 王翠芳[1] 程新宇[1] 王星[1] 张弘[2] 

机构地区：[1]沈阳医学院奉天医院病理科,沈阳110024 [2]中国医科大学病理教研室,沈阳110000

出　　处：《诊断病理学杂志》2010年第2期111-113,共3页Chinese Journal of Diagnostic Pathology

摘　　要：目的加深对乳腺上皮性病变的认识,提高病理冷冻切片诊断的准确率。方法收集乳腺上皮性病变术中冷冻切片745例,按照WHO(2003)乳腺肿瘤组织学分类诊断标准对照石蜡切片分析误诊及延迟诊断原因,总结诊断规律。结果745例乳腺上皮性病变的冷冻切片中,3例误诊为浸润性导管癌、髓样癌和实性神经内分泌癌,分别是由于取材、制片及认识不足所致(0.4%),均为假(-);延迟诊断34例(4.56%),其中导管原位癌、不典型导管增生和导管内乳头状瘤延迟诊断率较高。结论乳腺上皮性病变具有形态多样性和易混淆性,有必要提高对冷冻切片诊断的认识水平和经验。Objective To increase the accuracy of frozen section diagnosis, and to enhance the realization on breast epithelial leisions. Methods Frozen and paraffin section diagnosis was retrospectively analyzed in 745 cases of breast epithelial lesions, according to 2003 WHO Classification of Tumours of the Breast. Then the diagnostic rules were summarized. Results In the 745 cases of frozen sections, 3 cases were underdiagnosed. The missed diagnosis were invasive ductal carcinoma, medullary carcinoma and solid neuroendocine carcinoma due to sampling, aeetioning and deficiency in experience. They accounted for 0. 4%. 34 cases were delayed diagnosis, accounting for 4.56%. Ductal carcinoma in situ, atypical duetal hyperplasia and intraductal papilloma were the most common in the delayed diagnosis. Conclusion Epithelial lesions of the breast are morphologically diverse and can be easily misdiagnosed. It is necessery to increase pathologists＇ diagnostic experience and understanding level in frozen section.

关 键 词：乳腺上皮性病变 冷冻切片 误诊 延迟诊断 分析 

分 类 号：R737.9[医药卫生—肿瘤]