ENDOMETRİAL KANSERLERİN İNTRAOPERATİF DEĞERLENDİRİLMESİNİN GÜVENİLİRLİĞİ

Year 2024, Volume: 3 Issue: 1, 46 - 50, 18.03.2024

Sevil Sayhan , Ayşe Gül Tavukçu , Duygu Ayaz , Gamze Aköz , Esra Canan Kelten Talu , Tuğba Karadeniz

https://doi.org/10.57221/izmirtip.1306811

Abstract

Amaç: Endometrial kanser gelişmiş ülkelerde jinekolojik maligniteler arasında ilk sıradadır.
Bilateral salpingooferektomiyle birlikte total histerektomi; erken evre endometrial
karsinomlarda standart tedavidir. Histolojik tip, myometrial invazyon, tümörün histolojik
derecesi ve servikal tutulum ek cerrahi prosedürleri gerektirir. Patoloğun intraoperatif tanısı
bu süreçte yol göstericidir. Bu çalışmanın amacı; laboratuvarımızda, endometrial karsinomun
evreleme cerrahi prosedürü sırasında intraoperatif frozen tanının güvenilirliğini
değerlendirmektir.
Gereç ve Yöntem: Çalışmamızda 2019 ocak ayı ile 2022 nisan ayı arasında, endometrial
karsinom ve atipili endometrial hiperplazi ön tanısı ile frozen çalışılan olguların hepsi
taranmış olup; 212 olgudan, frozen raporlarına ulaşılabilen 151 olgu değerlendirilmeye
alınmıştır. Histolojik tip ve derece, tümör çapı, myometrial invazyon, servikal ve adneksiyal
tutulum; frozen ve parafin kesitlerinde retrospektif olarak değerlendirilmiştir. Tümör çapı <2
cm ve ≥2 cm olarak , myometrial invazyon ise %50’den yüzeyel ve %50’den derin olarak
kategorize edilmiştir.
Bulgular: Frozen kesitlerin parafin kesitlerle uyumluluğu; histolojik tip için %98.6,
histolojik derece için %74.8, myometriyal invazyon için %82.8, tümör çapı için %90.7,
servikal invazyon için %91.4 ve over metastazı için %99.3 olarak bulunmuştur.
Sonuç: Bölümümüzde uygulanan endometrial kanserlerin intraoperatif frozen tanı sonuçları,
parafin tanı sonuçları ile büyük oranda uyumludur. Bu durum şimdiye kadar ortaya konan
ilgili literatür ile benzerlik göstermektedir. Sonuçta hastaların morbiditesi yüksek olan
gereksiz lenfadenektomiye maruz kalmaması için intraoperatif frozen prosedürü gerekli ve
güvenilir bir uygulamadır.

Keywords

endometrial karsinom, frozen kesit, endometrial kanser

RELIABILITY OF INTRAOPERATIVE ASSESSMENT OF ENDOMETRIAL CANCERS

Abstract

Aim: Endometrial cancer is the most common gynecological malignancies in developed
countries. Total hysterectomy with bilateral salpingoophorectomy is the standard treatment
for early stage endometrial carcinomas. Histological type, myometrial invasion, histological
grade of tumor, and cervical involvement require additional surgery. The pathologist’s
intraoperative diagnosis provides guidance in this process. The aim of this study is to assess
the reliability of intraoperative frozen diagnosis in our laboratory during surgical operations
for staging endometrial carcinoma.
Materials and Methods: We screened all cases between January 2019 and April 2022, which
we applied frozen sectioning with preliminary diagnosis of endometrial carcinoma and
endometrial hyperplasia with atypia. Out of 212 cases, we focused on 151, whose frozen
section reports were accessible. Histological type and grade, tumor diameter, myometrial
invasion, cervical and adnexal involvement were evaluated retrospectively in frozen and
paraffin sections. Tumor diameter was categorized as <2 cm and ≥2 cm, myometrial invasion
was categorized as more superficial than 50% and deeper than 50%.
Results: Compatibility of frozen sections with paraffin sections are found as 98.6% for
histological type, 74.8% for histological grade, 82.8% for myometrial invasion, 90.7% for
tumor diameter, 91.4% for cervical invasion, and 99.3% for ovarian metastasis.
Conclusion: The results of intraoperative frozen diagnosis of endometrial cancers performed
in our department are largely consistent with the results of paraffin diagnosis. This result is
concordant with what has been shown in the literature. Intraoperative frozen procedure is
necessary and reliable to avoid unnecessary lymphadenectomy in patients with high
morbidity.

Keywords

frozen section, endometrial cancer, endometrial carcinoma

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