title: Utility of frozen section pathology with endometrial pre-malignant lesions.
abstract: OBJECTIVE
  To determine utility of the frozen section (FS) in the operative management of endometrial pre-malignant lesions.
  
  
  METHODS
  We retrospectively analyzed patients who underwent abdominal hysterectomy with preoperative diagnosis of complex atypical endometrial hyperplasia (CAEH) and simple endometrial hyperplasia (SEH) between May 2007 and December 2013. Frozen and paraffin section (PS) results were compared. Sensitivity, specificity, the positive predictive value (PPV), the negative predictive value (NPV) and the accuracy in predicting EC on FS were evaluated with 95% confidence intervals (CIs) for each parameter. The correlation between FS and PS was calculated as an κ coefficient.
  
  
  RESULTS
  Among 143 preoperatively diagnosed CAEH cases, 60 (42%) were malignant and 83 (58%) were benign in PS; and among 60 malignant cases diagnosed in PS, 43 (71%) were "malignant" in FS. Sensitivity, specificity, PPV and NPV for FS were 76%, 100%, 100% and 87.5%, respectively.
  
  
  CONCLUSIONS
  We found that FS is reliable and applicable in the management of endometrial hyperplasias. It is important that the pathologist should be experienced because FS for endometrial pre-malignant lesions has significant inter-observer variability. The other conclusion is that patients with the diagnosis of EH, especially those who are postmenopausal, should undergo surgery where FS investigation is available.
authors.affiliation: Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey E-mail : ozmurat@gmail.com.
authors.forename: Murat
authors.initials: M
authors.lastname: Oz
authors.forename: Emre
authors.initials: E
authors.lastname: Ozgu
authors.forename: Elmas
authors.initials: E
authors.lastname: Korkmaz
authors.forename: Hatice
authors.initials: H
authors.lastname: Bayramoglu
authors.forename: Salim
authors.initials: S
authors.lastname: Erkaya
authors.forename: Tayfun
authors.initials: T
authors.lastname: Gungor
mesh_terms: D016022:Case-Control Studies; D004714:Endometrial Hyperplasia / Q000473:pathology* / Q000601:surgery*; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005629:Frozen Sections / Q000706:statistics & numerical data*; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies