乳腺病变275例术中快速冷冻切片病理诊断分析

Analysis of 275 cases of breast lesions intraoperative frozen section pathology diagnosis

目的:总结乳腺病变术中快速冷冻切片病理诊断的结果 ,探讨提高冷冻切片准确诊断乳腺病变的方法。方法:回顾性分析我院2009年1月-2012年10月行术中快速冷冻切片病理检查的275例乳腺病变的诊断资料。结果:275例乳腺病变术中冷冻切片诊断良性病变224例,恶性病变41例,交界性或延迟诊断10例,确诊率96.36%。恶性及可疑的均辅以术中组织细胞印片,共62例,其中良性13例,交界性或疑癌7例,恶性42例,确诊率88.71%。10例交界性或延迟诊断中3例经组织细胞印片得到确诊,两者结合确诊率97.45%。确诊病例中完全符合255例(占确诊率96.23%),基本符合10例(占确诊率3.77%);延迟诊断2例(延迟诊断率0.73%),误诊假阴性2例(误诊率0.73%),无假阳性病例。结论:提高冷冻切片诊断准确性必须详细了解患者临床资料,正确全面的取材,掌握常见乳腺病变病理诊断及鉴别要点,加强与临床医师沟通,提高冷冻切片质量。

Objective： To summarize the experience of quick frozen section pathological diagnosis in breast lesions opera- tions,and discuss the method of improving the accuracy of frozen section in diagnosing breast lesions. Methods： Retrospectively analysing the materials of 275 cases of breast lesions which have quick frozen section pathological diagnosis from January 2009 to October 2012 in our hospital. Results： 224 cases are diagnosed with benign lesions in 275 cases of breast lesions intraoperative frozen section, 42 cases of malignant lesions, 10 cases of borderline diagnosis or delayed diagnosis, the rate of diagnosis is 96.36%. 62 cases are malignant and difficult qualitative with intraoperative histocyte imprint. 13 cases are benign ;7 cases are borderline or suspect, 42 cases are malignant. And the rate of diagnosis is 88.71%. 3 in 10 cases of borderline diagnosis or delayed diagnosis are diagnosed by histocyte imprint,the combined diagnosis rate is 97.45%. 255 cases are fully complied with the diagnosis which occupies 96.23%. 10 cases are in line with the diagnosis which occupies 3.77%. 2 cases of delayed diagnosis and 2 cases of misdiagnosis both occupy 0.73%. No case is false positive. Conclusion： Increasing the diagnosis accuracy of frozen section counts in knowing clinical data in detail,drawing materials correctly and comprehensively ,commanding common breast lesions pathologic diagnosis and differentiated points ;strengthening the communication with clinicians and improving the quality of frozen section.