术中冰冻切片检查高度宫颈上皮内瘤样病变冷刀锥切切缘的价值探讨

Frozen Section Examination of the Cervical Margin of Cervical Conization Specimens for High Squamous Intraepithelial Lesion

目的探讨术中冰冻切片检查高度宫颈上皮内瘤样病变冷刀锥切切缘的价值。方法回顾分析345例高度宫颈上皮内瘤样病变术中、术后病理切片检查宫颈冷刀锥切标本切缘情况,采用自我对照以确定术中冰冻切片检查宫颈冷刀锥切标本切缘阳性预测值、阴性预测值、敏感性及特异性。结果术中冰冻切片检查宫颈冷刀锥切标本切缘阳性预测值、阴性预测值、敏感性及特异性分别为87.5%、98.5%、84.2%和99.4%;宫颈锥切术后切缘阴性患者复发率为2.0%,而切缘阳性患者有50%患者病变持续存在。结论术中冰冻切片检查高度宫颈上皮内瘤样病变冷刀锥切标本切缘具有很高的准确率,可作为高度宫颈上皮内瘤样病变术中是否扩大手术范围的依据。

Objective To determine the value of frozen section examination of cervical margin during cold knife conization. Methods Between January 2003 and March 2005, 345 consecutive patients underwent cervical conization for high squamous intraepithelial lesion and frozen section of the cervical margin was processed. If the cervical margin was involved with intraepithelial neoplasia, the surgeon performed a second resection if possible. Results of the frozen section examination were compared with the final diagnoses to determine sensitivity, specificity, and positive and negative predictive values. Results For the diagnosis of high intraepithelial neoplasia involving the cervical margin, the sensitivity, specificity, and positive and negative predictive values of frozen section were 87.5% ,98.5%,84.2%,and 99.4 %, respectively. Conclusion Frozen section examination of the cervical margin of cervical specimen obtained during cold knife conization is highly accurate.