Are preoperative features effective in the incompatibility of intraoperative frozen section and final pathology in operated patients diagnosed with atypia endometrial hyperplasia?

Abstract

ABSTRACT Objective: We aim to investigate the relationship between demographic characteristics and preoperative laboratory findings with the discordance between intraoperative frozen section diagnoses and final diagnoses in patients undergoing surgery with endometrial hyperplasia with atypia. Methods: The study included 154 patients who underwent surgery for endometrial hyperplasia with atypia and who received intraoperative frozen section (IFS) diagnosis between January 2015 and January 2021. Frozen section diagnoses and the final diagnoses of the patients were compared. Patient groups were split into two: patients with an IFS diagnosis concordant and patients with an IFS diagnosis discordant with the final diagnosis. These two groups were compared regarding body mass index (BMI), age, systemic diseases, laboratory parameters and ultrasonography findings. Results: When final diagnoses and IFS diagnoses were contrasted, the results were concordant in 126 patients and discordant in 28 patients. The agreement rate was 81.8% (Kappa = 0.635; p < 0.001; significant agreement). When the concordant and discordant groups were compared regarding demographic characteristics and preoperative laboratory findings, it was found that the BMI was higher, and the rate of complex atypia in the preoperative pathological examination was higher in the discordant group (p < 0.05). Other inflammatory markers and demographic variables were not significantly different between groups (p > 0.05). Conclusion: Among patients operated for endometrial hyperplasia with atypia, IFS diagnoses were mostly concordant with the final diagnoses. It should be kept in mind that the discordance rate may be higher in atypical hyperplasias with complex structure and in patients with high BMI.

Keywords

• endometrial hyperplasia
• atypia
• complex
• malignancy
• frozen section

Atipili endometrial hiperplazi tanısı ile opere edilen hastalarda intraoperatif frozen patoloji ile nihai patoloji uyumsuzluğunda preoperatif özellikler etkili midir?

Abstract

ÖZET: Amaç: Atipili endometrial hiperplazi tanısı ile opere edilen hastalarda intraoperatif frozen section patoloji ile postoperatif final patoloji sonuçları arasındaki farklılıkların demografik özellikler ve preoperatif laboratuar bulguları ile ilişkisinin araştırılmasıdır. Yöntem: Kliniğimizde Ocak 2015-Ocak 2021 tarihleri arasında atipili endometrial hiperplazi nedeniyle opere olan ve intraoperatif frozen section patoloji (FSP) çalışılan 154 hasta çalışmaya alındı. Hastaların FSP ve postoperatif final patoloji sonuçları karşılaştırıldı. Hastalar FSP ve final patoloji uyumlu olanlar ve uyumlu olmayanlar olmak üzere iki gruba ayrıldı. Bu iki grup; yaş, vücut kitle indeksi (VKİ), sistemik hastalıklar, laboratuar parametreleri ve ultrasonografi bulguları açısından karşılaştırıldı. Bulgular: FSB ve final patoloji sonuçları karşılaştırıldığında 126 hastada sonuçlar uyumluyken 28 hastada sonuçlar uyumsuz olarak değerlendirildi. Uyumluluk oranı %81.8 olarak saptandı (Kappa=0.635; p<0.001; önemli derecede uyumlu). Uyumlu olan ve uyumlu olmayan gruplar demografik ve preoperatif laboratuar bulguları açısından karşılaştırıldığında uyumsuz grupta VKI’nin daha yüksek ve preoperatif patolojide kompleks atipi oranının daha fazla olduğu saptandı (p<0.05). Diğer demografik özellikler ve inflamatuar göstergeler açısından iki grup arasında fark saptanmadı (p>0.05). Sonuç: Atipili endometrial hiperplazi nedeniyle opere olan hastalarda FSP sonuçları büyük oranda final patoloji sonuçları ile uyum içerisindedir. Uyumsuzluk oranının kompleks yapılı atipili hiperplazilerde ve yüksek VKI sahip hastalarda daha fazla olabileceği akılda tutulmalıdır.

Keywords

• endometrial hiperplazi
• atipi
• kompleks
• malignite
• frozen section

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