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How accurate is frozen section pathology compared to permanent pathology in detecting involved margins and lymph nodes in breast cancer?
World Journal of Surgical Oncology ( IF 2.5 ) Pub Date : 2021-09-01 , DOI: 10.1186/s12957-021-02365-5
Zahra Mehdipour Namdar 1 , Navid Omidifar 2 , Peyman Arasteh 1 , Majid Akrami 1 , Sedigheh Tahmasebi 1 , Aida Salehi Nobandegani 1 , Sogol Sedighi 1 , Vahid Zangouri 1, 3 , Abdolrasoul Talei 2
Affiliation  

Frozen section (FS) pathology has multiple limitations, and different institutions report variable experiences with the use of FS for diagnosis of tumor involvement. We aimed to compare the FS accuracy with that of permanent pathology (gold standard) regarding marginal involvement and lymph node status using data from the largest breast cancer registry in Iran. In this retrospective study, women who had both FS and permanent pathology reports were included. The two pathology reports were cross compared with regard to the involvement of tumor margins and sentinel lymph nodes. Overall, 2786 patients entered the study. Mean age of patients was 48.96±11.44 years. A total of 1742 margins were analyzed. Accordingly, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FS pathology for detection of involvement of involved margins were 78.49%, 97.63%, 65.1%, and 98.7%, respectively. The accuracy and area under the curve (AUC) for FS pathology were 96.61% and 0.73 (95% CI: 0.64–0.831), respectively. A total of 1702 sentinel lymph node biopsies were assessed. Sensitivity, specificity, PPV, and NPV, of FS pathology for detection of lymph node involvement, were 87.1%, 98%, 95.5%, and 93.3%, respectively. Accuracy and AUC of FS for diagnosis of involved lymph nodes were 94.1% and 0.926 (95% CI: 0.909–0.942), respectively. Frozen pathology is a suitable method for identifying involved sentinel lymph nodes in patients with breast cancer, but this method has a less than optimum efficacy for detecting and confirming marginal involvement.

中文翻译:

与永久性病理学相比,冷冻切片病理学在检测乳腺癌的受累边缘和淋巴结方面的准确度如何?

冰冻切片 (FS) 病理学具有多种局限性,不同机构报告了使用 FS 诊断肿瘤受累的不同经验。我们的目的是使用来自伊朗最大的乳腺癌登记处的数据,将 FS 的准确性与永久病理学(金标准)的准确性进行比较,即关于边缘受累和淋巴结状态。在这项回顾性研究中,同时有 FS 和永久性病理报告的女性被包括在内。两份病理报告在肿瘤边缘和前哨淋巴结受累方面进行了交叉比较。总共有 2786 名患者进入了研究。患者的平均年龄为 48.96±11.44 岁。共分析了 1742 个边缘。因此,敏感性、特异性、阳性预测值 (PPV)、FS病理学检测受累边缘受累的阴性预测值(NPV)分别为78.49%、97.63%、65.1%和98.7%。FS 病理的准确度和曲线下面积 (AUC) 分别为 96.61% 和 0.73(95% CI:0.64–0.831)。总共评估了 1702 个前哨淋巴结活检。FS 病理学检测淋巴结受累的敏感性、特异性、PPV 和 NPV 分别为 87.1%、98%、95.5% 和 93.3%。FS 诊断受累淋巴结的准确度和 AUC 分别为 94.1% 和 0.926(95% CI:0.909–0.942)。冷冻病理学是识别乳腺癌患者受累前哨淋巴结的合适方法,但该方法在检测和确认边缘受累方面的效果欠佳。和 98.7%,分别。FS 病理的准确度和曲线下面积 (AUC) 分别为 96.61% 和 0.73(95% CI:0.64–0.831)。总共评估了 1702 个前哨淋巴结活检。FS 病理学检测淋巴结受累的敏感性、特异性、PPV 和 NPV 分别为 87.1%、98%、95.5% 和 93.3%。FS 诊断受累淋巴结的准确度和 AUC 分别为 94.1% 和 0.926(95% CI:0.909–0.942)。冷冻病理学是识别乳腺癌患者受累前哨淋巴结的合适方法,但该方法在检测和确认边缘受累方面的效果欠佳。和 98.7%,分别。FS 病理的准确度和曲线下面积 (AUC) 分别为 96.61% 和 0.73(95% CI:0.64–0.831)。总共评估了 1702 个前哨淋巴结活检。FS 病理学检测淋巴结受累的敏感性、特异性、PPV 和 NPV 分别为 87.1%、98%、95.5% 和 93.3%。FS 诊断受累淋巴结的准确度和 AUC 分别为 94.1% 和 0.926(95% CI:0.909–0.942)。冷冻病理学是识别乳腺癌患者受累前哨淋巴结的合适方法,但该方法在检测和确认边缘受累方面的效果欠佳。总共评估了 1702 个前哨淋巴结活检。FS 病理学检测淋巴结受累的敏感性、特异性、PPV 和 NPV 分别为 87.1%、98%、95.5% 和 93.3%。FS 诊断受累淋巴结的准确度和 AUC 分别为 94.1% 和 0.926(95% CI:0.909–0.942)。冷冻病理学是识别乳腺癌患者受累前哨淋巴结的合适方法,但该方法在检测和确认边缘受累方面的效果欠佳。总共评估了 1702 个前哨淋巴结活检。FS 病理学检测淋巴结受累的敏感性、特异性、PPV 和 NPV 分别为 87.1%、98%、95.5% 和 93.3%。FS 诊断受累淋巴结的准确度和 AUC 分别为 94.1% 和 0.926(95% CI:0.909–0.942)。冷冻病理学是识别乳腺癌患者受累前哨淋巴结的合适方法,但该方法在检测和确认边缘受累方面的效果欠佳。
更新日期:2021-09-01
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