Analysis of intraoperative frozen section examination results in 1756 cases of mesenchymal tumors of the uterine corpus:a 12-year retrospective study at a tertiary referral center
LIU Liu-liu
XU Xiao-feng
LI Zhi-wen
ZHENG Jin-yu
LIU Hua
ZHANG Yan
LI Rong
TANG Xiao-qiu
ZHU Xiang-hong
LING Jing-xian
ZHOU Huai-jun
Abstract：Objective To investigate the accuracy of intraoperative frozen section examination in mesenchymal tumors of the uterine corpus and determine its clinical application value.Methods The clinical and pathological data of patients were analyzed retrospectively,who underwent surgical treatment and intraoperative frozen section examination and were diagnosed with mesenchymal tumors of the uterine corpus by routine pathological examination at Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2011 to March 2023.The concordance rate and discordance rate between diagnosis by intraoperative frozen section examination and diagnosis by routine pathological examination were calculated,as well as the deferral rate of diagnosis.The sensitivity,specificity,positive predictive value and negative predictive value of intraoperative frozen section examination in benign,borderline and malignant mesenchymal tumors of the uterine corpus were figured out respectively.The proportion of patients who underwent a change in surgical procedure was calculated.Results(1)General characteristics:A total of 1756 patients with mesenchymal tumors of the uterine corpus underwent intraoperative frozen section examination,of which 1696(96.58％)were benign,23(1.31％)were borderline,and 37(2.11％)were malignant.The median age was 44(38-48)years old.(2)The frozen section and routine pathological diagnoses were concordant in 1673 cases(95.27％)and discordant in 16 cases(0.91％),and deferred diagnosis was in 67 cases(3.82％).The concordance rates of benign,borderline and malignant mesenchymal tumors were 97.29％,8.7％and 56.76％,respectively.(3)The sensitivity of intraoperative frozen section examination for benign,borderline and malignant mesenchymal tumors of the uterine corpus was 99.82％,20.00％and 80.77％,respectively;the specificity was 63.89％,99.88％and 99.94％,respectively;the positive predictive values were 99.21％,50.00％and 95.45％,respectively;the negative predictive values were 88.46％,99.53％and 99.70％,respectively.(4)A total of 8 cases underwent a change in surgical procedure,accounting for 44.44％(8/18)of the patients who needed it.Conclusions The overall accuracy of intraoperative frozen section examination for mesenchymal tumors of the uterine corpus is generally high.The positive prediction value of intraoperative frozen section examination in malignant mesenchymal tumors is high,and the rate of misdiagnosis as malignancy is very low.A secondary surgery can be avoided by a change in the surgical procedure according to intraoperative frozen section examination.
Keywords：mesenchymal tumors of the uterine corpusintraoperative frozen section examinationroutine pathological examinationaccuracyclinical application value
Publication Date：2025-08-02
Online Publishing Date：2025-09-30(First online date of this platform, not the publication date of the document)
Pages：6( 836-841 )