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我院1989～1991年间共行卵巢手术1176例,其中术中作冰冻切片124例,占10.5%。回顾性分析124例的冰冻切片原始诊断并与石蜡切片病理诊断比较,结果其中5例上皮性肿瘤的冰冻与石蜡切片病理诊断不符,包括4例诊断不足和1例诊断过度。尚有3例冰冻切片诊断不确定,冰冻与石蜡切片诊断符合率93.5%。冰冻切片对诊断卵巢恶性肿瘤的总敏感度为96.6%,总特异度98.5%。在上皮性肿瘤,对诊断良性肿瘤的敏感度为97.3%,特异度94.7%;交界性肿瘤的敏感度78.9%,特异度98.3%;恶性肿瘤的敏感度87.5%,特异度100%。提示冰冻切片对诊断卵巢交界性和恶性上皮性肿瘤的敏感度较低。冰冻切片有一定的局限性,不能代替石蜡切片。提出临床医师应提高对卵巢肿瘤大体观的识别能力,术时冰冻切片以控制在15%以下为宜。
Our hospital from 1989 to 1991, a total of 1176 cases of ovarian surgery, including intraoperative frozen section in 124 cases, accounting for 10.5%. A retrospective analysis of 124 cases of frozen sections of the original diagnosis and pathological diagnosis of paraffin sections compared to 5 cases of epithelial tumor frozen paraffin sections and pathological diagnosis, including 4 cases of inadequate diagnosis and 1 case of overexposure. There are three cases of frozen section of the diagnosis is uncertain, frozen and paraffin section diagnosis consistent rate of 93.5%. Frozen sections for the diagnosis of ovarian cancer, the total sensitivity was 96.6%, the total specificity of 98.5%. In epithelial tumors, the sensitivity to diagnose benign tumors was 97.3% and the specificity was 94.7%. The borderline tumors were 78.9% and 98.3% respectively. The sensitivity and specificity of malignant tumors were 87.5% and 100% respectively. Tip frozen section of the diagnosis of ovarian borderline and malignant epithelial tumor sensitivity is low. Frozen sections have some limitations, can not replace the paraffin section. It is suggested that clinicians should improve their ability to recognize ovarian tumors in general, and frozen sections should be controlled below 15% at the same time.