The Accuracy of Frozen Section in the Diagnosis of Malignant Adnexal Masses

Yıl 2016, Cilt: 43 Sayı: 1, 18 - 21, 01.03.2016

Nuri Yıldırım Alkım Şahingöz Yıldırım Ahmet Ergenoğlu Ahmet Yeniel Osman Zekioğlu Necmettin Özdemir M. Coşan Terek

Öz

Objective: To measure the accuracy of the frozen section in the diagnosis of malignant adnexal masses.
Methods: 192 patients who had been operated due to adnexal masses and submitted for intraoperative frozen section were evaluated retrospectively. The results were compared with paraffin section.
Results: In all cases, opinion on frozen section was available. The sensitivity of frozen section through benign, borderline and malignant tumors were 98.8%, 90% and 93.8% respectively, where as the specificity of the latter tumors were 92.3%, 98.9% and 100% respectively. The overall accuracy was 97.9%. Two benign cases were diagnosed as borderline, one borderline as benign and one malignant case as a benign in frozen section. The misdiagnosed malignant case was mucinous and the others were serous type tumors.
Conclusion: Frozen section has high accuracy in the diagnosis of malignant ovarian tumors. Paraffin section is the gold standard method, but because of the need for the quick result in the operation for the surgical management, frozen section must be performed to all suspicious adnexal masses.
Key words: Adnexal mass, frozen section, paraffin section

Anahtar Kelimeler

-

Malign Adneksiyal Kitlelerin Tanısında Donuk (Frozen) Kesit İncelemesinin Doğruluğu

Öz

Amaç: Malign adneksiyal kitlelerin tanısında donuk (frozen) kesit incelemesinin doğruluğunun belirlenmesiYöntemler: Adneksiyal kitle nedeniyle opere edilen ve operasyon sırasında donuk kesit incelemesi istenen 192 hasta retrospektif olarak incelenmiştir. Sonuçlar parafin kesit sonuçlarıyla karşılaştırılmıştır.Bulgular: Tüm olgularda, donuk kesit incelemesine yanıt verilebilmiştir. Donuk kesit incelemesinin, benign kitleleri saptamadaki duyarlılığı, %98,8; borderline (hudut) kitleleri saptamadaki duyarlılığı %90; malign kitleleri saptamadaki duyarlılığı ise %93,8 saptanmıştır. Spesifisite sırasıyla %92,3, %98,9 ve %100 saptanmıştır. Toplamda doğruluk oranı ise %97,9 bulunmuştur. Donuk kesitler parafin kesitlerle karşılaştırıldığında, iki benign olguya yanlış olarak borderline, bir borderline olguya benign, bir malign olguya ise benign tanısı konulmuştur. Yanlış tanı konulan malign olgu müsinöz tip, diğer benign ve borderline olgular ise seröz tip over tümörüdür.Sonuç: Donuk kesit incelemesi, malign adneksiyal kitleleri saptamada yüksek duyarlılığa sahiptir. Parafin kesit altın standart yöntemdir, ancak operasyon sırasında cerrahi müdahalenin şekli için daha hızlı yanıt gereklidir. Bu nedenle, donuk kesit incelemesi şüpheli adneksiyal kitlelerin cerrahi tedavisinde hızlı sonuç verdiği için tüm adneksiyal kitlelere uygulanmalıdır

Anahtar Kelimeler

Adneksiyal kitle, donuk kesit, parafin kesit

Kaynakça

• Yancik R. Ovarian cancer. Age contrasts in incidence, histology,
• disease stage at diagnosis, and mortality. Cancer 1993;71:517-523.
• Wakahara F, Kikkawa F, Nawa A, et al. Diagnostic efficacy of tumor markers, sonography and intraoperative frozen section for ovarian tumors. Gynecol Obstet Invest 2001;52:147-152.
• Lim FK, Yeoh CL, Chong SM, et al. Pre and intraoperative diagnosis of ovarian tumours: how accurate are we? Aust NZ J Obstet Gynaecol 1997;37:223–227.
• Rose PG, Rubin RB, Nelson BE, et al. Accuracy of frozensection
• (intraoperative consultation) diagnosis of ovarian tumors. Am J Obstet Gynecol 1994;171:823-826.
• Kudela M, Marek R, Pilka R, et al. Benefits and the accuracy of the intra-operative frozen section at suspected ovarian tumours. Ceska Gynekol 2015;80:250-255.
• Alabalık U, Avcı Y, Keleş AN, et al. Five year evaluation of intraoperative pathology consultations in a university hospital. Dicle Med J 2013;40:207-211.
• Ilvan S, Ramazanoglu R, Ulker Akyildiz E, et al. The accuracy
• of frozen section (intraoperative consultation) in the diagnosis of ovarian masses. Gynecol Oncol 2005;97:395-399.
• Twaalfhoven FC, Peters AA, Trimbos JB, et al. The accuracy of frozen section diagnosis of ovarian tumors. Gynecol Oncol 1991;41:189–192.
• Maiman M, Seltzer V, Boyce J. Laparoscopic excision of ovarian neoplasms subsequently found to be malignant. Obstet Gynecol 1991;77:563–565.
• Puls L, Heidtman E, Hunter JE, et al. The accuracy of frozen
• section by tumor weight for ovarian epithelial neoplasms. Gynecol Oncol 1997;67:16–19.
• Usubutun A, Altinok G, Kucukali T. The value of intraoperative
• consultation (frozen section) in the diagnosis of ovarian neoplasms. Acta Obstet Gynecol Scand 1998;77:10131016.
• Yeo EL, Yu KM, Poddar NC, et al. The accuracy of intraoperative
• frozen section in the diagnosis of ovarian tumors. JObstet Gynaecol Res 1998;24:189–195.
• Wang KG, Chen TC, Wang TY, et al. Accuracy of frozen section diagnosis in gynecology. Gynecol Oncol 1998;70:105–110.
• Gol M, Baloglu A, Yigit S, et al. Accuracy of frozen section diagnosis in ovarian tumors: is there a change in the course of time? Int J Gynecol Cancer 2003;13:593–597.
• Medeiros LR, Rosa DD, Edelweiss MI, et al. Accuracy of frozen-section analysis in the diagnosis of ovarian tumors: a systematic quantitative review. In J Gynecol Oncol 2005;15:192-202.
• Acs G. Intraoperative consultation in gynecologic pathology.
• Semin Diagn Pathol 2002;19:237–254.