3436例卵巢肿瘤术中冰冻病理检查结果分析  

Analysis of intraoperative frozen section examination in 3436 ovarian tumors.

作　　者：刘柳柳 徐晓峰[1] 李志文[2] 郑金榆[2] 周怀君[1] Liu Liuliu;Xu Xiaofeng;Li Zhiwen(Department of Gynecology,Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing210008;Department of Pathology,Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing210008)

机构地区：[1]南京大学医学院附属鼓楼医院妇科,南京210008 [2]南京大学医学院附属鼓楼医院病理科,南京210008

出　　处：《现代妇产科进展》2024年第9期641-647,共7页Progress in Obstetrics and Gynecology

基　　金：江苏省自然科学青年基金(No:BK20210024);江苏省卫健委医学科研面上项目(No:H2019012)。

摘　　要：目的:探讨卵巢肿瘤术中冰冻病理检查的准确性。方法:回顾分析2011年1月至2023年3月在南京大学医学院附属鼓楼医院妇科接受手术治疗,术中行冰冻病理检查,且常规病理检查诊断为卵巢四大肿瘤(包括上皮性肿瘤、生殖细胞肿瘤、性索间质肿瘤、转移性肿瘤)的患者的临床病理资料。评估术中冰冻病理检查诊断卵巢原发肿瘤良恶性的准确性,计算良性、交界性、恶性卵巢肿瘤术中冰冻病理检查的敏感性、特异性、阳性预测值、阴性预测值;评估术中冰冻病理检查鉴别卵巢原发恶性肿瘤组织学分型的准确性;评估术中冰冻病理检查对卵巢转移性肿瘤定性为转移的准确性。结果:(1)术中冰冻病理检查诊断卵巢原发肿瘤良恶性的总体准确率为93.58%,其中交界性黏液性肿瘤、黏液性癌、未成熟畸胎瘤、颗粒细胞瘤的诊断准确率分别为70.16%、52.94%、46.15%、77.14%;卵巢良性、交界性、恶性肿瘤术中冰冻病理检查总体敏感性分别为99.40%、80.95%、92.99%;总体特异性分别为92.80%、98.38%、99.49%。(2)术中冰冻病理检查鉴别卵巢原发恶性肿瘤组织学分型的总体准确率为94.39%,其中无性细胞瘤、卵黄囊瘤的准确率较低,分别为61.11%、58.33%。(3)术中冰冻病理检查对卵巢转移性肿瘤定性为转移的准确率为53.78%,其中阑尾来源的准确率极低,为22.22%。结论:术中冰冻病理检查对卵巢肿瘤诊断的总体准确性高,但在交界性黏液性肿瘤、黏液性癌、未成熟畸胎瘤、颗粒细胞瘤的良恶性判断,无性细胞瘤和卵黄囊瘤的组织学分型及转移性肿瘤定性转移方面准确性差。Objective:To investigate the accuracy of intraoperative frozen section examination in ovarian tumors.Methods:The clinicopathological data of patients who underwent surgical treatment with intraoperative frozen section and were diagnosed as ovarian tumors by permanent section at Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2011 to March 2023 were analyzed.The accuracy of intraoperative frozen section examination in the diagnosis of malignant potential of primary ovarian tumors was evaluated.The sensitivity,specificity,positive predictive value and negative predictive value of intraoperative frozen section examination in benign,borderline and malignant ovarian tumors were calculated respectively.The accuracy of intraoperative frozen section examination in differentiating histological types of primary ovarian malignancies was evaluated.The accuracy of intraoperative frozen section examination in identifying the primary or secondary nature of ovarian metastatic tumor was evaluated.Results:(1)The overall accuracy rate of frozen section examination in the diagnosis of malignant potential of primary ovarian tumors was 93.58%,and the accuracy rates of borderline mucinous tumor,mucinous carcinoma,immature teratoma and granulosa cell tumor were 70.16%,52.94%,46.15%and 77.14%,respectively.The overall sensitivity of intraoperative frozen section examination for benign,borderline and malignant ovarian tumors were 99.40%,80.95%and 92.99%,respectively.The overall specificity were 92.80%,98.38%and 99.49%,respectively.(2)The overall accuracy rate of intraoperative frozen section examination in differentiating histological types of primary ovarian malignancies was 94.39%,and the accuracy rates of dysgerminoma and yolk sac tumor were 61.11%and 58.33%,respectively.(3)The accuracy rate of intraoperative frozen section examination in identifying the primary or secondary nature of ovarian metastatic tumor was 53.78%,and the accuracy of tumors metastasized from the appendix was very low(22.22%).Conclu

关 键 词：卵巢肿瘤 术中冰冻病理检查 常规病理检查 准确性 良恶性质 组织学分型 转移性肿瘤 

分 类 号：R737.31[医药卫生—肿瘤]