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.
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.
Wang
Xipeng
X
Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Zhang
Hui
H
Di
Wen
W
Li
Weiping
W
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