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目的探讨术中冷冻检查在乳腺癌肿瘤组织级别和肿物组织学大小中的诊断价值及其诊断准确性的影响因素。方法选取柳州钢铁集团有限公司医院2011年5月—2016年5月收治的乳腺癌患者88例,患者术前均未实施化疗或放疗治疗。术中实施冰冻切片诊断,以术后石蜡病理诊断为金标准。比较术中冷冻切片与术后石蜡病理诊断对乳腺癌患者肿瘤组织级别、组织学大小的诊断价值,并分析影响冰冻诊断准确率的影响因素。结果患者冰冻诊断结果与术后病理组织级别符合率为78.4%(69/88)。其中Ⅰ级、Ⅱ级、Ⅲ级乳腺癌诊断符合率分别为70.0%(14/20)、75.0%(36/48)、95.0%(19/20)。患者术中冷冻诊断结果与术后病理组织学大小符合率为87.5%(77/88)。其中癌肿组织学大小≤3 cm诊断符合率为85.3%(58/68),癌肿组织学>3 cm诊断符合率为95.0%(19/20)。术中冷冻切片癌肿组织学>3 cm诊断符合率高于癌肿组织学大小≤3 cm诊断符合率(P<0.05)。术中冷冻切片在诊断乳腺癌病理组织级别、组织学大小时,绝经后患者诊断符合率高于绝经前,>3 cm患者诊断符合率高于≤3 cm(P<0.05)。结论术中冷冻检查与术后病理检查在乳腺癌患者肿瘤组织级别和肿物组织学大小的诊断结果不完全相符,且绝经后乳腺肿块患者、肿物组织学越大,术中冷冻切片诊断准确率越高。
Objective To investigate the diagnostic value and diagnostic accuracy of intraoperative cryoablation in breast cancer tissue grade and histological size. Methods Eighty-eight patients with breast cancer admitted to the hospital of Liuzhou Iron and Steel Group Co., Ltd. from May 2011 to May 2016 were selected. None of the patients received chemotherapy or radiotherapy before operation. Intraoperative frozen section diagnosis, pathological diagnosis of paraffin after the gold standard. To compare the diagnostic value of intraoperative frozen section and paraffin pathological diagnosis of breast cancer patients with tumor grade and histological size, and analyze the influencing factors that affect the accuracy of frozen diagnosis. Results The coincidence rate of frozen diagnosis and postoperative pathological grade was 78.4% (69/88). The coincidence rates of grade Ⅰ, grade Ⅱ and grade Ⅲ breast cancer were 70.0% (14/20), 75.0% (36/48) and 95.0% (19/20), respectively. The coincidence rate of intraoperative frozen diagnosis and postoperative histopathology was 87.5% (77/88). The coincidence rate of histological size ≤ 3 cm was 85.3% (58/68) and that of cancerous tissue> 3 cm was 95.0% (19/20). Intraoperative frozen section of the tumor histological> 3 cm diagnostic coincidence rate higher than the size of the tumor ≤ 3 cm diagnostic coincidence rate (P <0.05). Intraoperative frozen section in the diagnosis of breast cancer pathological tissue size, histological size, postmenopausal diagnosis is higher than pre-menopausal patients,> 3 cm diagnostic accuracy was higher than ≤ 3 cm (P <0.05). Conclusions Intraoperative cryoablation and postoperative pathological examination are not completely consistent with the diagnostic results of tumor tissue grade and histological size in patients with breast cancer, and the histological size of the tumor in postmenopausal women with breast mass is larger and the intraoperative frozen section diagnosis is accurate The higher the rate.