An Exploration Of The Value Of Frozen Pathology For Comprehensive Surgical Staging Of Early Endometrial Carcinoma

[Objective] Endometrial cancer is one of the three malignant tumors of female genital tract. Surgical is the first choice treatment, it needs comprehensive surgical-pathologic staging. However, at present the intraoperative frozen section’s value in guiding comprehensive surgical staging of Endometrial cancer is controversial. Through the analysis of recent six years in the Second Affiliated Hospital of Chong Qing Medical University of surgical treatment of patients with endometrial cancer clinical medical records for the first time, based on the related clinical data of statistical analysis, compare the intraoperative frozen section and the postoperative paraffin pathological results, evaluate the accuracy of the intraoperative frozen section and the value of comprehensive surgical staging.[Method] Using the electronic medical records management system, I collected the clinical dates of patients with EC who got surgical treatment in the Second Affiliated Hospital of Chong Qing Medical University for the first time from January 2010 to December 2015.The data was drawn out through comparing and analyzing the consistencies and differences of diagnosis of intraoperative frozen section and postoperative paraffin pathological on the tumor histological grading and myometrial invasion.All statistical data was input into Excel table. Using Kappa and Mc Nemar test with SPSS21.0 statistical software.[Result] The overall concordance rate in tumor grade was 68.75%(44/64) between frozen section and permanent pathology. The concordance rate of G1,G2 and G3 differential tumor cell was respectively 90.90%(20/22), 71.43%(20/28) and 66.67%(4/6).The Kappa test result was 0.538,medium consistency, and the difference was statistically significant through the Mc Nemar testing(χ2=9.667,P=0.046).The concordance rate of depth of myometrial invasion was 57.81%(37/64). The diagnosis coincidence rate of class I, II and III was respectively 26.67%( 4/15) 、 80.65%( 25/31) 、 80.00%(8/10). The Kappa test result was 0.343, poor consistency, and the difference was statistically significant through the Mc Nemar testing(χ2=12.000,P=0.035)[Conclusion] 1, Intraoperative frozen section compared with postoperative paraffin pathologica in the diagnosis of endometrial carcinoma, medium consistency ii histologic classification and poor in myometrial invasion. So intraoperative frozen section can not accurately evaluate the histologic classification or myometrial invasion.2. It is not necessary to Comprehensive surgical stage depending on intraoperative frozen section.