小体积肺腺癌术中冷冻诊断的准确性及影响因素分析

Factors of accuracy of intraoperative cryogenic diagnosis for small lung adenocarcinoma

目的:分析小体积肺腺癌术中冷冻病理诊断准确性及影响因素。方法:选取2021年2月—2023年1月儋州市人民医院收治的72例疑似小体积肺腺癌患者,均进行术中冷冻病理诊断,以术后石蜡切片病理诊断为“金标准”,分析影响冷冻病理诊断准确性的因素。结果:以金标准结果为准,术中冷冻切片病理诊断符合率为88.89%(64/72),误诊率为9.72%(7/72),漏诊率为1.39%(1/72)。术中冷冻切片病理诊断与术后蜡切片病理诊断相符合64例,不符合8例。造成不符合的原因与患者吸烟、肿瘤大小、高级别组织学形态等因素有关。经Logistic因素分析,吸烟、肿瘤大小、高级别组织学形态是影响诊断符合率的主要因素,差异有统计学意义(P<0.05)。结论:小体积肺腺癌术中冷冻切片病理诊断具有一定的准确性,且是手术治疗方案拟定的重要依据,但诊断时,仍需结合肿瘤大小,是否存在高级别组织学亚型等因素,以提高诊断准确性。

Objective To analyze the factors of the accuracy of intraoperative cryogenic diagnosis of small lung adenocarcinoma.Methods A total of 72 patients with suspected small volume lung adenocarcinoma admitted to our hospital from February 2021 to January 2023 were selected as the research objects.All of them underwent intraoperative cryogenic diagnosis,and paraffin section diagnosis after surgery was used as the“gold standard”to analyze the clinicopathological factors affecting the diagnostic accuracy.Results Based on the gold standard results,the accuracy rate of intraoperative cryogenic diagnosis was 88.89%(64/72),the misdiagnosis rate was 9.72%(7/72),and the missed diagnosis rate was 1.39%(1/72),with 64 cases conforming and 8 cases not confirmed.The reasons for the incompatibility were related to smoking,tumor size and other factors of the patients.Logistic analysis showed that smoking,tumor size and high-grade histological morphology were the main factors that caused the inconformity of diagnostic accuracy,and the difference was statistically significant(P<0.05).Conclusions The intraoperative pathological diagnosis of small-volume lung adenocarcinoma with frozen sections has some accuracy and is an important research in the formulation of surgical treatment plan.However,it is still necessary to actively improve the diagnostic accuracy by considering the tumor size and the existence of high-grade histological subtypes during the diagnosis.