title: Clinical factors affecting the diagnostic accuracy of assessing dilation and curettage vs frozen section specimens for histologic grade and depth of myometrial invasion in endometrial carcinoma.
abstract: OBJECTIVE
  We sought to investigate clinical factors affecting accuracy of dilation and curettage (D&C) and frozen section diagnosis of endometrial cancer.
  
  
  METHODS
  Clinical parameters affecting concordance of D&C or frozen section compared with final hysterectomy pathology were analyzed in 218 patients with endometrial cancer.
  
  
  RESULTS
  The overall concordance of grade between D&C and final hysterectomy findings was 35.2% (62/176). The following factors increased accuracy of D&C: depth of uterus cavity > or = 9 cm (P = .043), deep (> 50%) myometrial invasion (P = .03), P53 positivity (P = .023), grade 2 (P = .01), and grade 3 (P = .048). When comparing frozen section with final hysterectomy findings, the concordance was 69% (58/84) in tumor grade and 87% (67/77) in myometrial invasion. Postmenopausal bleeding (P = .004) and less resistance index of endometrial lesion blood flow (P = .005) increased efficacy of grade diagnosis by frozen section.
  
  
  CONCLUSIONS
  Discordance with hysterectomy assessment was most common for women with D&C or frozen section diagnoses of low-grade superficial cancers.
authors: Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
authors: Xipeng
authors: X
authors: Wang
authors: Hui
authors: H
authors: Zhang
authors: Wen
authors: W
authors: Di
authors: Weiping
authors: W
authors: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004107:Dilatation and Curettage; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D005629:Frozen Sections / Q000592:standards*; D006801:Humans; D007044:Hysterectomy; D007432:Intraoperative Period; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology* / Q000601:surgery; D009361:Neoplasm Invasiveness / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012720:Severity of Illness Index