Intraoperative evaluation of myometrial invasion and histological type and grade in endometrial cancer: diagnostic value of frozen section.

摘要

PURPOSE: We have conducted a retrospective, comparative analysis of the accuracy of preoperative diagnosis and frozen section diagnosis relative to postoperative diagnosis. METHODS: Subjects consisted of 168 patients with endometrial cancer, and frozen section was also performed. The diagnostic accuracy and the under-diagnosis rates in regard to both the myometrial invasion (MI) and the histological type and grade (HTG) were determined. RESULTS: The diagnostic accuracy rate for preoperative HTG and MI were 64.3 and 54.8%, while the under-diagnosis rate was 25.0 and 35.7%. In contrast, the corresponding diagnostic accuracy rate for frozen HTG and MI were 84.5 and 85.7%, while under-diagnosis was 9.5 and 9.5%. Statistical analysis showed that the diagnostic accuracy rate for HTG and MI were significantly higher with frozen section diagnosis than with preoperative diagnosis (P<0.0001) and the under-diagnosis rate for HTG and MI were significantly lower with frozen section diagnosis than with preoperative diagnosis (P<0.0001). CONCLUSIONS: Frozen section diagnosis was clearly more effective than preoperative diagnosis involving MRI as a basis for deciding the operative technique for endometrial cancer.