| Background:Cervical cancer is the most common tumor of gynecology.Each year,there are about 135,000 new cases of cervical cancer in China.The patient of cervical intraepithelial lesions is younger than it,and the most common aged is 25-35 years old.It can be divided into low-grade squamous intraepithelial lesions(LSIL),high-grade squamous intraepithelial neoplasia(HSIL),and adenocarcinoma in situ(AIS).HSIL and AIS need active surgical treatment.There are two common treatments:loop electrosurgical excision procedure(LEEP)and cold knife conization(CKC).Freezing pathology(Rapid pathology)can be used as an important reference of the range of local resection of cervical lesions,and whether or not needs the cervical resection or cervical cancer radical surgery,to avoid secondary surgery.The guiding role of rapid pathology in the local resection of cervical lesions can be divided into two aspects:first,to determine whether the remnant lesions of the cervix remnants or not;second,whether it has progressed to invasive cervical cancer.Purpose:The purpose of this study was to evaluate the diagnostic value of frozen pathology for cervical tissue from the remnants of cervical margin lesions and invasive cervical cancer.(and to analyze the differences between the two surgical procedures.)Materials and methods:I collected rapid pathological and routine postoperative pathology(paraffin sections)in cervical lesions at the Department of Gynaecology at the Shandong Provincial Hospital from 2011.01.01 to 2017.12.31.According to the different surgical methods,the patients were divided into two groups:LEEP group and CKC group,with a total of 1047 patients in the LEEP group and 695 in the CKC group.Edge of resection with LSIL,HSIL,CIN,AIS,and invasive carcinoma(including abnormal/hyperplasia)are marked as positive.Those with marginal disease-free tissues(including cervicitis,squamous metaplasia,and normal glandular hyperplasia)are marked as negative.I count cutting edge and grades of lesions of negative and positive cases,and comparing the findings of rapid pathological and conventional pathological.I count cervical cancer and cancerous size of negative and positive cases,and comparing the findings of rapid pathological and conventional pathological.I countthefollow-up treatment measures for patients whose rapid pathological findings were abnormal.Result:The overall accuracy of the margin was 97.76%.The margin accuracy of the LEEP group was 97.13%,the sensitivity was 80.20%,the specificity was 98.94%,the positive predictive rate was 89.01%,and the negative predictive rate was 97.91%.The accuracy of the cold knife conical resection group was 98.70%,the sensitivity was 88.89%,the specificity was 99.24%,the positive predictive rate was 86.49%,and the negative predictive rate was 99.39%.The rapid pathology of the cervical LEEP group and the CKC group had a high degree of consistency with the conventional pathology in resection margin tissue type.The overall accuracy of type Ⅰ rapid pathology report of cervical invasive carcinoma was 99.17%,the accuracy of LEEP group was 98.92%,and the specificity was 100%,the positive predictive rate was 100%,the negative predictive rate was 98.91%.The accuracy of the CKC group was 99.56%,and the specificity was 100%,the positive predictive rate was 100%,the negative predictive rate was 99.54%;The rate of surgical treatment was 66.41%in patients with positive pathological resection margins,and 24.66%in patients with positive or suspected invasive cancers.Conclusion:1.The accuracy of rapid pathology for edge of resection is 97.76%,which has a high guiding value for judging cut or not and determining the range of surgical excision.2.The accuracy of rapid pathology for the diagnosis of cervical cancer is 99.17%,which has a high diagnostic value for intraoperative diagnosis and exclusion of cervical cancer. |
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