手术中冰冻切片诊断卵巢肿瘤859例分析

An analysis of 859 cases of frozen section diagnosis of ovarian tumors during operation

目的：总结冰冻切片诊断卵巢肿瘤的体会。方法：回顾性分析８５９例卵巢肿瘤冰冻切片诊断资料。结果：利用冰冻切片诊断卵巢肿瘤，确诊率９４．８８％，未能确诊率０．５８％，误诊率４．５４％。误诊３９例，多见于交界性粘液囊腺瘤，分化好粘液囊腺癌和转移性粘液腺癌；４例冰冻切片误诊的良性肿瘤包括２例卵巢甲状腺肿和２例粘液囊腺瘤。误诊原因中，取材不当占５３．８８％，读片错误３５．９０％，制片不良１０．２８％。结论：冰冻切片是手术中确定卵巢肿瘤性质的有效方法。提高取材技术、掌握疑难病例大体表现和镜下特征和必要时辅助印片和组化染色。

Purpose To summarize experience from frozen section diagnosis of ovarian tumors. Methods Eight hundred and fiftynine ovarian tumors frozen section diagnoses were analyzed retrospectively. Results The accurate rate of the frozen section method for ovarian tumors was 9488%, the uncertain rate 058%, the inaccurate rate 454%. In the 39 misdiagnosed cases, major histologic types were mucinous tumors of borderline malignancy, welldifferentiated mucinous cystadenocarcinomas and metastatic mucinous adenocarcinomas. The 4 benign ovarian tumors misdiagnosed in frozen section comprised two struma ovarii and two mucinous cystadenomas. In the causes of misdiagnosis, sampling error accounted for 5388%, interpretation error 3590%, bad section 1028%. Conclusion Frozen section can be an effective method in histologic diagnosis of ovarian tumors during operation. It is possible that improving sampling technique, mastering the gross appearances and microscopic features of difficult cases, if desirable, supplementary with smear cytological examination and histochemical staining can increase the accuracy of frozen section diagnosis of ovarian tumors.