术中冷冻切片与细胞学涂片对卵巢肿瘤的病理诊断分析

Intraoperative frozen section and cytological smear for pathological diagnosis of ovarian tumors

目的分析术中冷冻切片与细胞学涂片对卵巢肿瘤的病理诊断。方法本研究选取2020年2月至2022年2月在平顶山市第一人民医院就诊的卵巢肿瘤患者95例,均进行术中冷冻切片与细胞学涂片,以石蜡标本病理诊断为金标准,统计术后石蜡切片诊断结果,对比术中冷冻切片、细胞学涂片的检测时间,比较术中冷冻切片、细胞学涂片、术中冷冻切片联合细胞学涂片诊断卵巢肿瘤诊断效能(准确度、灵敏度、特异度)及符合率,分析影响联合诊断准确性的单因素及多因素。结果术中冷冻切片所用时间高于细胞学涂片(P<0.05);在95例卵巢肿瘤患者中,经过金标准石蜡切片诊断显示,58例为良性肿瘤,37例为恶性肿瘤;术中冷冻切片、细胞学涂片准确度、灵敏度均低于联合检测(P<0.05);术中冷冻切片、细胞学涂片、联合检测特异度比较差异无统计学意义(P>0.05);联合检测诊断卵巢肿瘤符合率为98.95%,高于术中冰冻切片、细胞学涂片(P<0.05);单因素分析显示,性别、年龄、多病灶等单因素比较差异无统计学意义(P>0.05);淋巴结转移、肿瘤直径差异有统计学意义(P<0.05);采用Logistic多因素回归分析显示淋巴结转移、肿瘤直径是影响联合病理诊断准确性的独立危险因素(P<0.05)。结论术中冷冻切片诊断卵巢肿瘤的准确性相对略高,细胞学涂片检测所用时间较短,联合检测效能好于单一检测,但其准确性可能受淋巴结转移、肿瘤直径的影响,对临床手术方案的制定具有一定价值。

【Objective】To analyze the pathological diagnosis of ovarian tumors by intraoperative frozen section and cytology smear.【Methods】In this study,95 patients with ovarian tumors who were treated in our hospital from February 2020 to February 2022 were selected for intraoperative frozen sections and cytological smears.The pathological diagnosis of paraffin specimens was the gold standard,and the postoperative diagnosis of paraffin sections was counted.The detection time of intraoperative frozen section and cytological smear was compared,and the diagnostic efficacy(accuracy,sensitivity,specificity),the coincidence rate of intraoperative frozen section,cytological smear,and intraoperative frozen section combined with cytological smear for the diagnosis of ovarian tumors were compared.The single factor and multiple factors affecting the accuracy of combined diagnosis were analyzed.【Results】The time of intraoperative frozen section was higher than that of cytological smear(P<0.05).Among 95 patients with ovarian tumors,58 cases were diagnosed as benign tumors and 37 cases were malignant tumors after standard paraffin section diagnosis;the accuracy and sensitivity of intraoperative frozen sections,cytological smear were lower than those of combined detection(P<0.05);the specificity of intraoperative frozen section,cytological smear and combined detection had no significant difference(P>0.05);the coincidence rate of combined detection of ovarian tumors was 98.95%,higher than that of intraoperative frozen section and cytology smear(P<0.05);univariate analysis showed that there was no significant difference in gender,age,multiple lesions and other univariate factors(P>0.05);there was significant difference in lymph node metastasis and tumor diameter(P<0.05);Logistic multivariate regression analysis showed that lymph node metastasis and tumor diameter were independent risk factors affecting the accuracy of combined pathological diagnosis(P>0.05).【Conclusion】The accuracy of intraoperative frozen section in diagnosing ovarian tumors is relatively slightly higher.The time required for cytological smear detection is shorter,and the combined detection efficiency is better than that of single detection.However,its accuracy may be affected by lymph node metastasis and tumor diameter,which has certain value for the development of clinical surgical plans.