[Analysis of diagnosis accuracy of frozen sections in 73 cases of borderline tumor of ovary].
OBJECTIVE
To assess the sensitivity and positive predictive value (PPV) of intraoperative frozen section diagnosis of the borderline tumor of ovary (BTO).


METHODS
A retrospective analysis and comparison were done respectively between the accuracies of diagnoses made by using frozen and paraffin sections from the same tissue blocks for BTO from March 1995 to May 2008 achieved in the Department of Pathology, Guangdong General Hospital. Univariate and multivariate regression models were used to assess the influence of patient and tumor characteristics on the likelihood of underdiagnosis and overdiagnosis.


RESULTS
Of the 73 patients analyzed, 39 cases (53.42%) were histologically serous tumors, 32 (43.84%) were mucinous and 2 (2.74%) were endometrioid tumors. Diagnoses identical in those made by using either frozen or routine paraffin sections were 55/73 (75.34%). The sensitivity and positive predictive value of frozen section diagnosis were 87.30% and 85.94%, respectively. Underdiagnosis of frozen section were 18/73 (24.66%). There was no overdiagnosis cases obtained. Univariate analysis showed that tumor diameter and tumor histology were the predictors of underdiagnosis in frozen section analysis. And in multivariate analysis, only tumor diameter, rather than patient age, tumor histology and stage, bilateral side tumor, serum CA-125 and concurrent presence of endometriosis was a predictor of underdiagnosis.


CONCLUSIONS
Intraoperative frozen section diagnosis of BTO has a low sensitivity and PPV. Underdiagnosis is not uncommon. Surgical management based on intraoperative frozen section diagnosis should be used with caution.
Li
Min
M
Department of Pathology, Guangdong Provincial People's Hospital, Guangzhou 510080, China.
Liu
Yan-hui
YH
Zhuang
Heng-guo
HG
Lin
Hua-huan
HH
Zeng
Ren-hai
RH
Wang
Xiao-bing
XB
Mei
Ping
P
Luo
Dong-lan
DL
Luo
Xin-lan
XL
Zhang
Wei
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018394:CA-125 Antigen / Q000378:metabolism; D018269:Carcinoma, Endometrioid / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D018291:Cystadenoma, Mucinous / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D018293:Cystadenoma, Serous / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007432:Intraoperative Period; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D016612:Paraffin Embedding; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
D018394:CA-125 Antigen