前哨淋巴结术中冷冻切片与印片细胞学诊断子宫颈癌与子宫内膜癌转移的评价分析  

Accuracy evaluation of frozen section and imprint cytology in diagnosis of cervical cancer and endometrial cancer metastasis in sentinel lymph node surgery

作　　者：孟洁琼 范柳倩 肖飞盈 Meng Jieqiong;Fan Liuqian;Xiao Feiying(Department of Pathology,University of Chinese Academy of Sciences Cancer Hospital(Zhejiang Cancer Hospital),Hangzhou 310022,China;Institute of Basic Medicine and Oncology,Chinese Academy of Sciences,Hangzhou 310022,China)

机构地区：[1]中国科学院大学附属肿瘤医院(浙江省肿瘤医院)病理科,浙江杭州310022 [2]中国科学院基础医学与肿瘤研究所,浙江杭州310022

出　　处：《实用肿瘤杂志》2022年第1期77-81,共5页Journal of Practical Oncology

摘　　要：目的探究术中前哨淋巴结冷冻切片与印片细胞学对子宫颈癌和子宫内膜癌转移的诊断准确性。方法纳入2018年10月至2020年10月于中国科学院大学附属肿瘤医院接受前哨淋巴结活检并且进行术中冷冻切片分析和印片细胞学检查的63例子宫颈癌和112例子宫内膜癌患者。术中切片分析和印片细胞学诊断的准确性与最终石蜡包埋切片病理学诊断结果进行比较。结果总计活检前哨淋巴结535个,其中35个存在肿瘤细胞转移。冷冻切片、印片细胞学以及2种方法联合检查的敏感度分别为77.1%、71.4%和91.4%,联合检查的敏感度高于单一检查(P=0.018),特异度均为100.0%,阴性预测值分别为98.4%、98.0%和99.4%。宏转移时3种检查方法敏感度分别为86.6%、86.6%和100.0%(P=0.030),微转移中为71.2%、71.2%和92.9%(P=0.042)。结论对于诊断子宫颈癌和子宫内膜癌采用前哨淋巴结术中冷冻切片和印片细胞学检查能够获得良好的准确性,并且联合检查比单独检查的敏感度更高。Objective To explore the diagnostic accuracy of intraoperative frozen section and imprint cytology of sentinel lymph node for cervical cancer and endometrial cancer metastasis. Methods Sixty-three patients with cervical cancer and 112 patients with endometrial cancer who underwent sentinel lymph node biopsy and had intraoperative frozen section analysis and imprint cytology from October 2018 to October 2020 in University of Chinese Academy of Sciences Cancer Hospital were enrolled. The accuracy of intraoperative frozen section analysis and imprint cytology in diagnosing metastasis was compared with the final pathological diagnosis results of paraffin-embedded sections. Results A total of 535 sentinel lymph nodes were biopsied, of which, 35 had tumor cell metastasis. The sensitivities of frozen section, imprint cytology and the combined examination of the two methods were 77.1%, 71.4%, and 91.4%, respectively, with the sensitivity of combined examination higher than that of single examination(P=0.018), the specificities were all 100.0%, and the negative predictive values were 98.4%, 98.0% and 99.4%, respectively. The sensitivities of the three inspection methods were 86.6%, 86.6%, and 100.0%(P=0.030) for macro metastasis, and 71.2%, 71.2%, and 92.9% for micro metastasis(P=0.042). Conclusions For the diagnosis of cervical cancer and endometrial cancer, the intraoperative frozen section and imprint cytology of sentinel lymph node can obtain good accuracy, and the combined examination is more sensitive than the single examination.

关 键 词：子宫颈癌 子宫内膜癌 前哨淋巴结活检 印片细胞学 冷冻切片 

分 类 号：R737.33[医药卫生—肿瘤]