摘要
目的:探讨乳腺病变冷冻切片诊断的准确性和提高准确性的方法,促进临床和病理的联系,共同提高对冷冻切片的认识。方法:回顾性对比分析天津医科大学附属肿瘤医院1988年1月至2001年12月术中10501例次乳腺病变冷冻切片与石蜡切片诊断结果。结果:在10501例次冷冻切片诊断报告中,确诊10356例次,确诊率为98.62%;误诊106例次,其中假阴性105例次,占1.00%,假阳性1例次,占0.01%;未确诊39例次,占0.37%。假阳性1例为乳头管腺瘤。假阴性较多见于叶状囊肉瘤、乳头状瘤病癌变、乳腺癌化疗后、导管内癌、浸润性导管癌及乳头状癌等。未确诊的病变中,乳头状病变、导管上皮不典型增生和叶状囊肉瘤待除外等病变较多,其次是乳腺癌化疗后炎性病变和颗粒细胞瘤。结论:冷冻切片取材的局限性、病变形态的多样性和冷冻切片的质量是造成误诊和未确诊的主要原因。只要熟练掌握乳腺病变的诊断和鉴别诊断要点,紧密加强病理与临床的相互联系,乳腺冷冻切片诊断是一种准确而可靠的术中诊断方法。
Objective:To explore the accuracy of frozen section examin at ion in breast dis-eases and the method to improve the accuracy,and to strength en the connection between clini cians and pathologists so as to enhance the real ization on frozen section examination.Methods:To analyse frozen and paraffin s ections diagnosis retrospectively in10501cases of breast diseases from19 88January to2001December in Cancer Hospital,Tianjin Medical University.R esults:In the10501cases of frozen sections,10356cases were definitel y diagnosed,accounting for98.62%;105cases(1%)were underdiagnosed ,and1case(0.01%)was overdiagnosed respectively;and39cases were diagn osed delayed,accounting for0.37%.The one case of false positive was diag-nosed finally as nipple ductal adenoma by paraffin section.And the underdiag nosed cases were usually exposed to cystosarcoma phyllode,papillomatosis cance ration,breast cancer after chemotherapy,intraductal carcinoma,infiltrative du ctal carcinoma and papillary carcinoma.In the cases of delayed diagnosis by fr ozen section,papillary disease,ductal epithelial atypical hyperpla-sia and cy stosarcoma phyllode were common,and inflammation in breast cancer after chemot hera-py and granular cell tumor were followed.Conclusion:The main reasons tha t cause misdelayed diagnosis are limitation and quality of frozen sections and diversity of disease morphology.As long as the main points of diagnosis and d ifferentiated diagnosis in breast diseases are mastered profi-ciently and the c onnection between clinicians doctors and pathologists is enhanced continually,f rozen section examination is an more accurate and reliable technique in breast d isease diagnosis during opera tion.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2003年第5期357-360,共4页
Chinese Journal of Clinical Oncology
关键词
乳腺病变
冷冻切片
诊断
分析
Breast Lesions Frozen Section Dia gnosis Analysis
