摘要
目的探讨术中冰冻诊断乳腺癌的临床价值及影响准确率的临床因素。方法回顾性研究2006年1月至2010年12月内蒙古自治区人民医院病理科诊断的95例乳腺癌患者的临床病理资料,应用2003年版世界卫生组织(WHO)乳腺癌分类,计算诊断肿瘤组织级别与肿物组织学大小的准确率,分析影响准确率的临床病理因素。结果以术后乳腺病理为标准,术中冰冻与术后病理的组织级别的总体符合率为75.8%(72/95)。其中Ⅰ、Ⅱ、Ⅲ级乳腺癌符合率分别为68.2%、75%、85.7%。通过术后病理比较证实,冰冻所得结果中16.8%(16/95)肿瘤级别上升,仅有7.4%(7/95)级别下降。95例肿物组织学大小的整体符合率为86.3%。在肿物组织学大小>3 cm,符合率为95.2%(20/21)显著高于肿物大小≤3 cm的符合率83.8%(62/74),差异有统计学意义。相符组与不相符组比较,绝经后乳腺肿块患者、X线钼靶示多发钙化点减少,是术中冰冻诊断组织级别准确性提高的临床因素。结论术中冰冻诊断乳腺癌组织级别和肿物组织学大小不能完全符合术后病理结果,肿瘤分化越差,肿物组织学越大,术中冰冻与术后乳腺病理诊断符合率就越高。
Objective To evaluate the accuracy of in tra-operative frozen section diagnosis in tumor grade and size of tumour compared with postoperative pathological findings in breast cancer patients in order to explore clinical value of frozen section.Methods The retrospective analysis was performed on ninety-five women diagnosed with breast cancer who were treated in the Inner Mongolia people＇s Hospital from Jan 2006 to Dec 2010.According to theWorld Health Organization classification of breast cancer（2003）,the concordance of tumor grade and size of tumor were compared between frozen section and final pathological findingsResults According to the postoperative pathological findings,the overall concordance rate in tumor grade was 75.8%（72/95）between frozen section and permanent pathology.The concordance rate of Ⅰ Ⅱ Ⅲ differential tumor cell was 68.2%、75%、85.7% respectively.About 16.8%patient＇s（16/95）tumor grade wasup graded,while only 7.4% patient＇s（7/95）was downgraded.The overall concordance rate of size of tumor was 86.3%;especially in the cases whose size of tumor was more than 3cm,the concordance rate was 95.2%（20/21）,which was significantly higher than the concordance rate of size of tumour less than 3cm（83.8%,62/74）（P0.05）.More postmenopausal patients（P0.05）and less calcification（P0.05） was found with increasing concordance rate of frozen section and final pathology.Conclusion The accuracy of frozen section is not correlated with final pathology entirely.Grade 3 and more size of tumour（3 cm）are associated with the higher concordance of frozen section and final pathology.
出处
《中国实验诊断学》
北大核心
2011年第10期1674-1677,共4页
Chinese Journal of Laboratory Diagnosis
关键词
乳腺癌
冰冻切片
组织学级别
breast cancer
frozen section
histological
