Factors Predicting Inaccuracy Between Frozen Section Analysis and Postoperative Pathology Results: A Tertiary Center Experience

Öz

FACTORS PREDICTING INACCURACY BETWEEN FROZEN SECTION ANALYSIS AND POSTOPERATIVE PATHOLOGY RESULTS: A TERTIARY CENTER EXPERIENCE ABSTRACT Objective: To evaluate the diagnostic accuracy and to identify the factors determining the inaccuracy between FS analysis and postoperative pathology results in our hospital. Materials and Methods: This study included 1435 patients with pelvic masses who underwent surgical intervention and FS consultation. Results: On univariate analysis, menopausal state, abnormal uterine bleeding, preoperative serum Ca125 level, preoperative leukocyte value, preoperative neutrophil value, tumor size, presence of cystic component, pathological findings in Doppler USG, ascites and cell type were found to have statistical significance for benign / borderline / malign discrimination. Menopausal state (p<0.0001), preoperative serum Ca125 level (p<0.0001) and tumor size (p<0.0001) were identified as independent predictors for determining inaccuracy between intraoperative and postoperative pathological evaluation. Inconsistency increased 2.5 times with a serum Ca125 > 35 IU/ml, 3.8 times with tumor size> 79 mm and 5 times in postmenopausal patients. For the discrimination of benign / borderline / malign definitions, FS results and final pathology results were compatible in 1250 (87%) patients while it was not in 185 (13%) patients. Conclusions: Increased preoperative serum Ca125 level was a predictor for inaccuracy between FS examination and postoperative pathology results. Also, tumor size ≥80 mm and menopausal state were related to misdiagnosis in FS results. Maximal effort should be done to minimize preventable errors during intraoperative FS analysis. Keywords: Frozen section, Pelvic mass, Inaccuracy, Borderline tumors

Anahtar Kelimeler

• Frozen section
• Pelvic mass
• Inaccuracy
• Borderline tumors

Frozen/Section Sonuçları ile Postoperatif Patoloji Sonuçları Arasındaki Uyumsuzluğu Öngören Faktörler: Tersiyer Merkez Sonuçları

Öz

ÖZ Amaç: Hastanemizde FS analizi ile postoperatif patoloji sonuçları arasındaki tanısal doğruluğu değerlendirmek ve yanlışlığı belirleyen faktörleri belirlemek. Gereç ve Yöntem: Bu çalışmaya cerrahi müdahale ve FS konsültasyonu uygulanan pelvik kitlesi olan 1435 hasta dahil edildi. Bulgular: Tek değişkenli analizde Benign/Borderline/Malign tanılarının ayırımında; menopoz durumu, anormal uterin kanama, ameliyat öncesi serum Ca125 seviyesi, ameliyat öncesi lökosit değeri, ameliyat öncesi nötrofil değeri, tümör boyutu, kistik komponent varlığı, Doppler USG'de patolojik bulgular, asit ve hücre tipi istatistiksel olarak anlamlı bulundu. Menopoz durumu (p<0,0001), preoperatif serum Ca125 düzeyi (p<0,0001) ve tümör boyutu (p<0,0001), intraoperatif ve postoperatif patolojik değerlendirme arasındaki yanlışlığı belirlemede bağımsız faktörler olarak belirlendi. Uyumsuzluk serum Ca125 > 35 IU/ml olduğunda 2.5 kat, tümör boyutu > 79 mm olduğunda 3,8 kat ve postmenopozal hastalarda 5 kat arttı. Benign / borderline / malign tanılarının ayrımında FS sonuçları ile nihai patoloji sonuçları 1250 (%87) hastada uyumluyken 185 (%13) hastada uyumlu değildi. Sonuçlar: Artmış preoperatif serum Ca125 seviyesi, FS sonuçları ile postoperatif patoloji sonuçları arasındaki yanlışlığı predikte eden bir faktördür. Ayrıca FS sonuçlarında tümör boyutu ≥80 mm olduğunda ve menopozal durum yanlış tanı ile ilişkiliydi. İntraoperatif FS analizi sırasında önlenebilir hataları en aza indirmek için azami çaba gösterilmelidir.

Anahtar Kelimeler

• Pelvik kitle
• Borderline tümörler
• Frozen/Section
• Uyumsuzluk

Kaynakça

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