Efficacy of Frozen Section Biopsy in the Diagnosis of Adnexal Neoplasms

Kim, Kwan Sik; Oh, Byoung Chan

Abstract

Recently, the possibility of inappropriate management of undiagnosed early cancers increased with spreading laparoscopic approach of adnexal tumors. The pathologic diagnosis of frozen section biopsy(FBx) guide the surgeon to perform the appropriate surgical procedure of adnexal tumors. This study was conducted to verify preliminarily the criteria for the laparoscopic management and determine the accuracy and efficacy of conditioned FBx according to the criteria. The inclusive criteria of FBx results in this study was designed by means of the preoperative transvaginal sonography(morphologic score >or=10) or tumor marker level of serum(CA-125 level>or=35 U/ml in postmenopause and >or=65 U/ml in postmenopause) or suspected gross findings of the malignancy during operation. On the other hand, cases which were convinced as dermoid cysts, endometriomas and advanced(>or=IIIb) ovarian cancers on the basis of gross findings were excluded in this study. Two hundred seventy-six operations of adnexal tumors were performed between January 1995 and June 1996 and 74 results of FBx were picked up in this study. The overall rate of conditioned FBx was 26.8%(74/276). The applied criterion in this study had the sensitivity of 0.97, specificity of 0.78, negative predictive value of 0.99, positive predictive value of 0.36. The accuracy of frozen sectional biopsy were 87.8% in the histopathologic diagnosis and 97.3% in the clinicopathologic diagnosis. The sensitivity, specificity, negative predictive value and positive predictive value for ovarian cancers(borderline+malignant) were 1 in all. It was thought that frozen sectional biopsy was a appropriate guide for the decision of methods during operation of adnexal tumors and that the criteria in this study could be used as a guideline for frozen section biopsy in the laparoscopic surgery of adnexal tumors.