冰冻病理检查诊断宫颈上皮内瘤变Ⅲ级和评估锥切组织边缘状态的作用

The Value of Frozen Section Examination in Diagnosis and Evaluation of Resection Margins of Conization in Cervical Intraepithelial Neoplasm Ⅲ

目的:探讨锥切标本行冰冻病理检查诊断宫颈上皮内瘤变Ⅲ级(CINⅢ)和评估锥切组织边缘是否有残留病灶的作用。方法:对2005年10月至2010年10月在我院住院的30例阴道镜下活检取材诊断为CINⅢ的患者行宫颈锥切术、保留的宫颈组织取材和子宫切除术,并对锥切标本和保留的宫颈取材组织术中行冰冻病理切片检查,分析比较冰冻病理检查结果与所有标本的石蜡病理检查结果及组织切缘病灶残留情况。结果:①所有患者的锥切标本冰冻病理检查结果与宫颈石蜡病理检查结果相符合,均诊断宫颈浸润癌3例,CINⅢ25例,CINⅡ2例。②锥切标本、锥切后宫颈取材组织的冰冻病理检查和术后宫颈和子宫石蜡病理检查结果均提示4例患者切缘阳性(CIN患者3例,宫颈浸润癌患者1例),4例切缘阳性的患者,行子宫切除术后其宫颈均发现有残留病灶。26例切缘阴性的患者,行子宫切除术后宫颈均没有发现残留病灶。结论:冰冻病理检查能有效诊断CINⅢ并评估锥切组织边缘是否有病灶残留。

Objective：To investigate the value of frozen section examination（FSE） in diagnosis and evaluation the residual disease status in resection margins of conization in cervical intraepithelial neoplasm（CIN） Ⅲ.Methods：30 patients hospitalized from October 2005 to October 2010 were diagnosed CINⅢby biopsy in colposcope underwent conization,biopsy in retaining cervix after conization and hysterectomy,FSE were done in cone cut specimens and biopsy tissues,comparing the results between FSE and Paraffin section examination（PSE） and the residual disease status of resection margins.Results：①The diagnosis of the FSE was concordant with PSE in all patients. 3 cases were diagnosed as invasion cervical cancer and 25 cases were CINⅢ,and 2 cases were CINⅡ by both FSE and PSE. ②There was residual disease in resection margins in cone cut specimens and biopsy tissues by FSE and PSE in 4 cases,whose cervix existed residual disease after hysterectomy. Among them,there were 1 invasion cancer and 3 CIN. 26 patients whose resection margins were negative had no residual disease in their cervix after hysterectomy.Conclusions：FSE is an effective method in diagnosis CIN Ⅲ and evaluation the resection margins of conization.