中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2009年
2期
106-109
,共4页
李旻%刘艳辉%庄恒国%林华欢%曾仁海%王小冰%梅平%罗东兰%骆新兰%张威
李旻%劉豔輝%莊恆國%林華歡%曾仁海%王小冰%梅平%囉東蘭%駱新蘭%張威
리민%류염휘%장항국%림화환%증인해%왕소빙%매평%라동란%락신란%장위
卵巢肿瘤%冷冻%敏感性与特异性
卵巢腫瘤%冷凍%敏感性與特異性
란소종류%냉동%민감성여특이성
Ovarian neoplasms%Freezing%Sensitivity and specificity
目的 评价卵巢交界性肿瘤(BTO)冷冻诊断的准确性和阳性预测值.方法 回顾性分析1995年3月至2008年5月广东省人民医院病理科诊断的BTO病例,单因素和多因素回归分析方法 用于评价患者及肿瘤特征对于不当诊断(低诊断和过诊断)的影响.结果 共有73例BTO患者入组,其中39例(53.42%)为浆液性肿瘤,32例(43.84%)为黏液性肿瘤,2例(2.74%)为宫内膜样肿瘤.冷冻诊断与石蜡诊断一致者为55/73(75.34%),冷冻诊断BTO的敏感性为87.30%,阳性预测值为85.94%.冷冻过诊断率为0,低诊断率为24.66%(18/73).在单因素分析中,肿瘤直径和肿瘤组织学类型与冷冻低诊断有关;在多因素回归分析中,肿瘤直径是预测低诊断的惟一自变量.而患者年龄、肿瘤分期、双侧卵巢肿瘤、血清CA-125和子宫内膜异位与冷冻低诊断无关.结论 术中冷冻诊断BTO的敏感性和阳性预测值较低,低诊断常常发生,外科医师应对BTO的冷冻诊断持谨慎态度.
目的 評價卵巢交界性腫瘤(BTO)冷凍診斷的準確性和暘性預測值.方法 迴顧性分析1995年3月至2008年5月廣東省人民醫院病理科診斷的BTO病例,單因素和多因素迴歸分析方法 用于評價患者及腫瘤特徵對于不噹診斷(低診斷和過診斷)的影響.結果 共有73例BTO患者入組,其中39例(53.42%)為漿液性腫瘤,32例(43.84%)為黏液性腫瘤,2例(2.74%)為宮內膜樣腫瘤.冷凍診斷與石蠟診斷一緻者為55/73(75.34%),冷凍診斷BTO的敏感性為87.30%,暘性預測值為85.94%.冷凍過診斷率為0,低診斷率為24.66%(18/73).在單因素分析中,腫瘤直徑和腫瘤組織學類型與冷凍低診斷有關;在多因素迴歸分析中,腫瘤直徑是預測低診斷的惟一自變量.而患者年齡、腫瘤分期、雙側卵巢腫瘤、血清CA-125和子宮內膜異位與冷凍低診斷無關.結論 術中冷凍診斷BTO的敏感性和暘性預測值較低,低診斷常常髮生,外科醫師應對BTO的冷凍診斷持謹慎態度.
목적 평개란소교계성종류(BTO)냉동진단적준학성화양성예측치.방법 회고성분석1995년3월지2008년5월광동성인민의원병이과진단적BTO병례,단인소화다인소회귀분석방법 용우평개환자급종류특정대우불당진단(저진단화과진단)적영향.결과 공유73례BTO환자입조,기중39례(53.42%)위장액성종류,32례(43.84%)위점액성종류,2례(2.74%)위궁내막양종류.냉동진단여석사진단일치자위55/73(75.34%),냉동진단BTO적민감성위87.30%,양성예측치위85.94%.냉동과진단솔위0,저진단솔위24.66%(18/73).재단인소분석중,종류직경화종류조직학류형여냉동저진단유관;재다인소회귀분석중,종류직경시예측저진단적유일자변량.이환자년령、종류분기、쌍측란소종류、혈청CA-125화자궁내막이위여냉동저진단무관.결론 술중냉동진단BTO적민감성화양성예측치교저,저진단상상발생,외과의사응대BTO적냉동진단지근신태도.
Objective To assess the sensitivity and positive predictive value(PPV) of intraoperative frozen section diagnosis of the borderline tumor of ovary(BTO).Methods A retrospective analysis and comparison were done respectively between the accuracies of diagnoses made by using frozen and paraffin sections from the satne tissue blocks for BTO from March 1995 to Mav 2008 achieved in the Department of Pathology,Guangdong General Hospital Univariate and multivariate regression models were used to assess the influence of patient and tumor characteristics on the likelihood of underdiagnosis and overdiagnosis.Results Of the 73 patients analyzed,39 cases(53.42%)were histologically serous tumors. 32(43.84%)were mucinous and 2(2.74%)were endometrioid tumors.Diagnoses identical in those made by using either frozen or routine paraffin sections were 55/73(75.34%).The sensitivity and positive predictive value of frozen section diagnosis were 87.30%and 85.94%.respectively.Underdiagnosis of frozen section were 18/73(24.66%).There Was no overdiagnosis cases obtained Univariate analysis showed that tumor diameter and tumor histology were the predictors of underdiagnosis in frozen section analysis.And in multivariate analysis,only tumor diameter,rather than patient age,tumor histology and stage,bilateral side tumor,serum CA-125 and concurrent presence of endometriesis was a predictor of underdiagnosis.Conclusions Intraoperative frozen section diagnosis of BTO has a low sensitivity and PPV. Underdiagnosis is not uncommon.Surgical management based on intranperative frozen section diagnosis should be used with caution.
