术中快速病理检查在子宫内膜癌及癌前病变诊断中的价值
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摘要
目的探讨术中快速病理检查在子宫内膜癌及癌前病变诊断中的应用价值。方法将行术中快速病理检查的107例子宫内膜癌及癌前病变患者的病历资料进行回顾性分析,并将术中快速病理检查结果与术后病理切片检查结果进行对比分析,观察术中快速病理检查子宫内膜癌及癌前病变的临床效果。结果以术后病理切片检查结果为标准,术中快速病理检查在子宫内膜癌及癌前病变诊断中的准确率为69.2%(74/107);术中快速病理检查子宫内膜癌G_1期的准确率为57.4%(35/61),G_2期的准确率为76.7%(23/30),G_3期的准确率为100%(16/16);术中快速病理检查子宫内膜癌癌变部位浸润Ⅰ级准确率为45.3%(24/53),Ⅱ级准确率为91.1%(41/45),Ⅲ级准确率为100%(9/9)。结论术中快速病理检查在子宫内膜癌及癌前病变诊断中的准确性较高,尤其是在癌症分期越高以及癌变部位浸润越深患者检查中的符合率更高,虽然术中快速病理检查存在一定限制,无法作为最终诊断,但可对子宫是否存在高危因素进行有效评估。
Objective To investigate the value of intraoperative rapid pathological examination in the diagnosis of endometrial carcinoma and precancerous lesions.Methods Retrospective analysis of 107 cases of endometrial carcinoma and precancerous lesions patiens who were performed intraoperative rapid pathological examination in our hospital from December 2013 to December 2016,and make a comparative analysis of intraoperative pathological examination results and postoperative pathological examination results to observe the clinical effect of intraoperative rapid pathological examination of endometrial carcinoma and precancerous lesions.Results The accuracy rate of intraoperative rapid pathological examination in the diagnosis of endometrial carcinoma and precancerous lesions was 69.2%(74/107).The accuracy rate of intraoperative rapid pathological examination of stage G_1 in endometrial carcinoma was 57.4%(35/61),the accuracy rate of G_2 was 76.7%(23/30),the accuracy rate of G_3 was 100%(16/16).The accuracy rate of intraoperative rapid pathological examination of grade Ⅰ in endometrial cancer site infiltration level was 45.3%(24/53).The accuracy rate of grade Ⅱ was 91.1%(41/45),the accuracy rate of grade Ⅲ was 100%(9/9).ConclusionIntraoperative rapid pathological examination in the diagnosis of endometrial carcinoma and precancerous lesions has high accuracy,especially in higher cancer staging and deeper invasion cancer site in the examination of patients with higher coincidence rate.Although the intraoperative rapid pathological examination has certain limitation as the final diagnosis,it can effectively assess whether on the existence of risk factors for the uterus.
Objective To investigate the value of intraoperative rapid pathological examination in the diagnosis of endometrial carcinoma and precancerous lesions.Methods Retrospective analysis of 107 cases of endometrial carcinoma and precancerous lesions patiens who were performed intraoperative rapid pathological examination in our hospital from December 2013 to December 2016,and make a comparative analysis of intraoperative pathological examination results and postoperative pathological examination results to observe the clinical effect of intraoperative rapid pathological examination of endometrial carcinoma and precancerous lesions.Results The accuracy rate of intraoperative rapid pathological examination in the diagnosis of endometrial carcinoma and precancerous lesions was 69.2%(74/107).The accuracy rate of intraoperative rapid pathological examination of stage G_1 in endometrial carcinoma was 57.4%(35/61),the accuracy rate of G_2 was 76.7%(23/30),the accuracy rate of G_3 was 100%(16/16).The accuracy rate of intraoperative rapid pathological examination of grade Ⅰ in endometrial cancer site infiltration level was 45.3%(24/53).The accuracy rate of grade Ⅱ was 91.1%(41/45),the accuracy rate of grade Ⅲ was 100%(9/9).ConclusionIntraoperative rapid pathological examination in the diagnosis of endometrial carcinoma and precancerous lesions has high accuracy,especially in higher cancer staging and deeper invasion cancer site in the examination of patients with higher coincidence rate.Although the intraoperative rapid pathological examination has certain limitation as the final diagnosis,it can effectively assess whether on the existence of risk factors for the uterus.
引文
[1]李晓旭.术中快速冰冻病理检查诊断子宫内膜癌的方法及应用价值评估[J].养生保健指南,2016,1(13):94-95.
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[6]张秀平.快速冰冻病理在98例子宫内膜癌手术中的临床价值[J].中国药物与临床,2016,16(3):399-400.
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[9]王琪,董艳.探析术中快速冰冻病理检查对子宫内膜癌的诊断意义[J].实用妇科内分泌电子杂志,2015,2(11):56-57.
[10]周海鸥.术中快速冰冻病理检查诊断子宫内膜癌的价值分析[J].河南医学研究,2014,23(5):45-46.
[11]Lee K,Sharma S,Jeremy B,et al.Origin and characterization of retrograde labeled neurons supplying the rat urethra using fiberoptic confocal fluorescent microscopy in vivo and immunohistochemistry[J].J Urology,2010,184(4):1550-4.
[12]季月霞,仲玉英,沈轶凡,等.术中快速冰冻病理检查诊断子宫内膜癌的价值探讨[J].中外女性健康研究,2016,1(14):204.
[13]Kendiric M,Trost L,Bakondi B,et al.Transplantation of nonhematopoietic adult bone marrow stem/progenitor cells isolated by p75 nerve growth factor receptor into the penis rescues erectile function in rat model of cavernous nerve injury[J].J Urology,2010,184(4):1560-6.
[14]何朝霞.子宫内膜癌诊断采用术中快速冰冻病理检查的临床体会[J].大家健康(下旬版),2014,1(10):429.
[15]陈作泉.术中快速冰冻病理检查诊断子宫内膜癌的价值探究[J].现代诊断与治疗,2015,1(2):289-291.
[2]江梅珍,金海燕,何凤仪,等.快速冰冻病理检查在子宫内膜癌术中的诊断价值[J].现代肿瘤医学,2015,1(16):2365-2367.
[3]Rump P,Niessen RC,Verbruggen KT.A novel mutation in MED12 causes FG syndrome(Opitz-Kaveggia syndrome)[J].Clin Gen,2011,79(2):183-8.
[4]李娟,刘建.冰冻病理检查对早期子宫内膜癌全面手术分期的价值[J].成都医学院学报,2015,10(6):715-717.
[5]肖海波.术中快速冰冻病理检查诊断子宫内膜癌的价值评价[J].中外医学研究,2014,1(12):58-59.
[6]张秀平.快速冰冻病理在98例子宫内膜癌手术中的临床价值[J].中国药物与临床,2016,16(3):399-400.
[7]Jennifer L,Susan L,Gayane Y,et al.Parent perspectives of health related quality of life for adolescents with bladder exstrophy-epispadias as measured by the child health questionnaire-parent form 50[J].J Urology,2010,184(4 Suppl):1656-1661.
[8]杨立,红芬.术中快速冰冻病理检查诊断子宫内膜癌的价值探讨[J].医学信息,2014,1(11):410.
[9]王琪,董艳.探析术中快速冰冻病理检查对子宫内膜癌的诊断意义[J].实用妇科内分泌电子杂志,2015,2(11):56-57.
[10]周海鸥.术中快速冰冻病理检查诊断子宫内膜癌的价值分析[J].河南医学研究,2014,23(5):45-46.
[11]Lee K,Sharma S,Jeremy B,et al.Origin and characterization of retrograde labeled neurons supplying the rat urethra using fiberoptic confocal fluorescent microscopy in vivo and immunohistochemistry[J].J Urology,2010,184(4):1550-4.
[12]季月霞,仲玉英,沈轶凡,等.术中快速冰冻病理检查诊断子宫内膜癌的价值探讨[J].中外女性健康研究,2016,1(14):204.
[13]Kendiric M,Trost L,Bakondi B,et al.Transplantation of nonhematopoietic adult bone marrow stem/progenitor cells isolated by p75 nerve growth factor receptor into the penis rescues erectile function in rat model of cavernous nerve injury[J].J Urology,2010,184(4):1560-6.
[14]何朝霞.子宫内膜癌诊断采用术中快速冰冻病理检查的临床体会[J].大家健康(下旬版),2014,1(10):429.
[15]陈作泉.术中快速冰冻病理检查诊断子宫内膜癌的价值探究[J].现代诊断与治疗,2015,1(2):289-291.