Frozen section examination of the endocervical margin of cervical conization specimens.
OBJECTIVE
We conducted this retrospective study to determine accuracy of frozen section examination of endocervical margin during cold knife conization.


METHODS
Between June 1993 and June 2001, 310 consecutive patients underwent cervical conization for squamous intraepithelial lesion or stage IA1 cervical cancer. Before 1997, the surgical specimens of 149 patients were processed following a standard pathological procedure (historical group). After 1997, a frozen section of the upper endocervical margin was processed during surgery for 161 patients. If the upper endocervical margin was involved with intraepithelial neoplasia, the surgeon performed a second resection if possible. Results of the frozen section examination were compared with the final diagnoses to determine sensitivity, specificity, and positive and negative predictive values. The usefulness of this procedure was evaluated by comparison of positive margin status rate with the one of the historical control group.


RESULTS
For the diagnosis of intraepithelial neoplasia involving the endocervical margin, the sensitivity, specificity, and positive and negative predictive values of frozen section were 91%, 100%, 100%, and 98%, respectively. Eleven patients had definitive positive endocervical margin in the frozen section group (three false negatives, six patients without additional resection, and two patients with intraepithelial neoplasia involving the upper margin of the additional resection) and 17 patients in the historical group (P =.16).


CONCLUSIONS
Frozen section examination of the endocervical margin of cervical specimen obtained during cold knife conization is highly accurate. Its clinical relevance has to be demonstrated in a multicenter study.
Rouzier
Roman
R
Department Obstetrics and Gynecology, Centre Hospitalier Intercommunal de Créteil, 40 avenue de Verdun, 94010 Créteil Cedex, France. roman.rouzier@wanadoo.fr
Feyereisen
Estelle
E
Constancis
Elisabeth
E
Haddad
Bassam
B
Dubois
Philippe
P
Paniel
Bernard-Jean
BJ
D000328:Adult; D019092:Conization / Q000379:methods*; D003452:Cryosurgery / Q000379:methods; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007432:Intraoperative Period; D015203:Reproducibility of Results; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000601:surgery