根治性宫颈切除术中淋巴结转移冰冻病理检查准确性的研究  

Accuracy of Pelvic Lymph Nodes Frozen Section Examination in the Procedure of Fertility-Conserved Trackelectomy

作　　者：钟森[1] 孙爱军[1] 沈铿[1] 杨佳欣[1] 曹冬焱[1] 

机构地区：[1]中国医学科学院北京协和医院,北京100730

出　　处：《实用妇产科杂志》2012年第8期668-670,共3页Journal of Practical Obstetrics and Gynecology

基　　金：国家十一五科技支撑计划(编号:2008BAI57B02)

摘　　要：目的:评价根治性宫颈切除术中盆腔淋巴结冰冻病理检查的准确性。方法:2003年12月至2012年2月北京协和医院妇产科收治的育龄期早期宫颈癌患者中共有38例患者要求保留生育功能而接受了根治性宫颈切除术,术中行盆腔淋巴结切除,并送冰冻病理检查,比较术中淋巴结快速冰冻切片及盆腔淋巴结石蜡切片结果。结果:38例患者的术中淋巴结冰冻病理检出4例淋巴结转移阳性,假阴性1例。术中淋巴结冰冻病理的敏感性80%,特异性100%,阴性预测值97%,阳性预测值100%。结论:术中淋巴结冰冻病理能较为准确地判断早期宫颈癌盆腔淋巴结的转移状况,但其可行性和安全性还需要更大样本量的前瞻性病例研究来进一步评价。Objectives： To analyze the accuracy of pelvic lymph nodes frozen section examination in the procedure of fertility-conserved trackelectomy for early stage of cervical cancer. Methods：A total of 38 con- secutive patients diagnosed as early stage cervical cancer,who wanted to maintain their fertility, registated in Peiking Union Medical College Hospital from December 2003 to February 2012. They underwent trackelectomy. During this procedure, systematic pelvic lymphadenectomy was done and pelvic lymph nodes were sent for intr- aoperative frozen section examination. The results of frozen section examination were compared with those of final histopathology. Results：Pelvic lymph nodes from 38 patients were analyzed both by frozen sectionexamination and by paraffin sections examination. Lymph node metastases were found in 4 cases （10.5%） at frozen section examination, and in 5 cases （13.2%） at definitive histological diagnosis. We found one false neg- ative diagnoses at frozen section examination. Sensitivity, specificity, negative predictive value, positive predic- tive value of frozen section examination was 80%, 100%, 97% and 100%, respectively. Conclusions： Frozen section analysis can predict the pelvic lymph node involvement in the procedure of trackelectomy accurately, and its feasibility and safety need be proved large-sample prospective case-controlled study.

关 键 词：早期宫颈癌 根治性宫颈切除 盆腔淋巴结 术中冰冻病理 

分 类 号：R737.33[医药卫生—肿瘤]