Nuri Yıldırım, Alkım Şahingöz Yıldırım, Ahmet Ergenoğlu, Ahmet Yeniel, Osman Zekioğlu, Necmettin Özdemir, M. Coşan Terek

Malign Adneksiyal Kitlelerin Tanısında Donuk (Frozen) Kesit İncelemesinin Doğruluğu

Amaç: Malign adneksiyal kitlelerin tanısında donuk (frozen) kesit incelemesinin doğruluğunun belirlenmesiYöntemler: Adneksiyal kitle nedeniyle opere edilen ve operasyon sırasında donuk kesit incelemesi istenen 192 hasta retrospektif olarak incelenmiştir. Sonuçlar parafin kesit sonuçlarıyla karşılaştırılmıştır.Bulgular: Tüm olgularda, donuk kesit incelemesine yanıt verilebilmiştir. Donuk kesit incelemesinin, benign kitleleri saptamadaki duyarlılığı, %98,8; borderline (hudut) kitleleri saptamadaki duyarlılığı %90; malign kitleleri saptamadaki duyarlılığı ise %93,8 saptanmıştır. Spesifisite sırasıyla %92,3, %98,9 ve %100 saptanmıştır. Toplamda doğruluk oranı ise %97,9 bulunmuştur. Donuk kesitler parafin kesitlerle karşılaştırıldığında, iki benign olguya yanlış olarak borderline, bir borderline olguya benign, bir malign olguya ise benign tanısı konulmuştur. Yanlış tanı konulan malign olgu müsinöz tip, diğer benign ve borderline olgular ise seröz tip over tümörüdür.Sonuç: Donuk kesit incelemesi, malign adneksiyal kitleleri saptamada yüksek duyarlılığa sahiptir. Parafin kesit altın standart yöntemdir, ancak operasyon sırasında cerrahi müdahalenin şekli için daha hızlı yanıt gereklidir. Bu nedenle, donuk kesit incelemesi şüpheli adneksiyal kitlelerin cerrahi tedavisinde hızlı sonuç verdiği için tüm adneksiyal kitlelere uygulanmalıdır

Anahtar Kelimeler:

Adneksiyal kitle, donuk kesit, parafin kesit

The Accuracy of Frozen Section in the Diagnosis of Malignant Adnexal Masses

Objective: To measure the accuracy of the frozen section in the diagnosis of malignant adnexal masses.Methods: 192 patients who had been operated due to adnexal masses and submitted for intraoperative frozen section were evaluated retrospectively. The results were compared with paraffin section.Results: In all cases, opinion on frozen section was available. The sensitivity of frozen section through benign, borderline and malignant tumors were 98.8%, 90% and 93.8% respectively, where as the specificity of the latter tumors were 92.3%, 98.9% and 100% respectively. The overall accuracy was 97.9%. Two benign cases were diagnosed as borderline, one borderline as benign and one malignant case as a benign in frozen section. The misdiagnosed malignant case was mucinous and the others were serous type tumors.Conclusion: Frozen section has high accuracy in the diagnosis of malignant ovarian tumors. Paraffin section is the gold standard method, but because of the need for the quick result in the operation for the surgical management, frozen section must be performed to all suspicious adnexal masses.Key words: Adnexal mass, frozen section, paraffin section

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