卵巢交界性肿瘤术中冰冻病理检查的诊断价值

Diagnostic value of intraoperative frozen pathology in ovarian borderline tumors

目的:探讨卵巢交界性肿瘤术中冰冻病理检查诊断的符合率及其影响因素。方法:回顾性分析2007年1月至2016年12月青岛大学附属医院妇科收治的253例卵巢交界性肿瘤患者的临床资料。结果:术中冰冻病理检查与术后常规病理检查结果一致者211例,不一致者42例,符合率83.40%。单因素分析显示肿瘤直径≥10 cm、CA125正常、非浆液性、FIGO分期Ⅰ期、无腹膜种植、交界成分<10%与病理检查不一致有关,多因素logi st ic模型分析显示病理类型是导致病理结果不一致的独立因素。病理结果不一致可致再分期手术增加,差异有统计学意义(χ^2=4.909,P=0.027)。结论:卵巢交界性肿瘤术前诊断困难,术中冷冻病理检查诊断具有较高的敏感性,病理类型是病理结果不一致的独立影响因素。

Objective: To investigate the diagnostic accuracy and influencing factors of frozen pathological examination in ovarian borderline tumors. Methods: The clinical data of 253 patients with ovarian borderline tumors admitted to the Department of Gynecology, Affiliated Hospital of Qingdao University from January 2007 to December 2016 were retrospectively analyzed. Results: The intraoperative frozen pathological examination was consistent with the results of postoperative pathological examination in 211 cases(83.40%), while the other 42 cases were inconsistent. Univariate analysis showed that patients with tumor diameter ≥10 cm, CA125 normal level, nonslurry pathological type, FIGO stage Ⅰ, no peritoneal implantation, or less than 10% of borderline components were associated with pathological inconsistency. Multivariate logistic analysis showed that pathological type was an independent factor for inconsistency between intra-and postoperative pathological diagnosis. Inconsistent pathological results can lead to increased re-surgery(χ^2=4.909, P=0.027). Conclusion: Preoperative diagnosis of ovarian borderline tumors is difficult. The intraoperative frozen pathological examination has high sensitivity. The pathological type is an independent influencing factor of pathological inconsistency between intraoperative frozen and postoperative paraffin pathological findings.