影响乳腺癌术中冰冻诊断准确性的病理与临床因素研究

Pathological and clinical factors study of influencing the accuracy of intraoperative frozen diagnosis of breast cancer

目的 分析乳腺癌患者手术过程中影响冰冻诊断准确性的病理条件以及临床因素,以促进冰冻诊断准确性的提高。方法 对2013年6月-2015年10月我院的85例（组织学肿瘤〉3 cm者45例、组织学肿瘤〈3 cm者40例）乳腺癌手术患者的临床资料进行回顾性分析,将其冰冻诊断结果与专业乳腺癌诊断分级进行比较,评价冰冻诊断的准确性,对影响冰冻诊断准确性的病理因素和临床因素进行详细探讨。结果 术中冰冻切片诊断对乳腺癌的诊断准确性为67.06%,Kappa=0.592,与术后病理诊断结果一致性中等。经多因素Logistic线性回归分析后确定,年龄、钙化情况、肿瘤直径、病理分级是影响乳腺癌术中冰冻诊断准确性的因素。结论 影响乳腺癌手术患者冰冻诊断准确性的因素较为复杂,因此在临床诊断过程中一定要注意考虑相关因素,以提高诊断的准确性,为乳腺癌患者的手术治疗提供科学的指导依据。

Objective To analyze the pathological and clinical factors of influencing the accuracy of intraoperative frozen diagnosis in the operation of breast cancer patients,so as to improve the diagnostic accuracy.Methods The clini- cal data of 85 cases of breast cancer （45 cases of histological tumor more than 3 cm, 40 cases of histological tumor less than 3 cm） patients from June 2013 to October 2015 in our hospital undergoing clinical medical records were retro- spectively analyzed.The results of frozen diagnosis and professional grade breast cancer diagnosis were compared to e- valuate the accuracy of frozen diagnosis.The pathological factors and clinical factors affecting the accuracy of frozen di- agnosis were discussed in detail.Results The diagnostic accuracy of frozen section in the diagnosis of breast cancer was 67.06%,Kappa value was 0.592,which was consistent with the results of postoperative pathological diagnosis.After multi- ple factors Logistic regression analysis,age,calcification,tumor diameter and pathological grading were the factors influ- encing the accuracy of intraoperative frozen diagnosis of breast cancer.Conclusion The effect of breast cancer patients with frozen diagnostic accuracy of factors is complex,therefore the related factors must be payed attention in the process of clinical diagnosis to improve the diagnostic accuracy and to provide scientific guidance for surgical treatment of patients with breast cancer.