Accuracy of Frozen Sections for Intraoperative Diagnosis of Complex Atypical Endometrial Hyperplasia


Objective: The purpose of this study was to correlate the histological diagnosis made during intraoperativefrozen section (FS) examination of hysterectomy samples with complex atypical endometrial hyperplasia (CAEH)diagnosed with definitive paraffin block histology.
Methods: FS pathology results of 125 patients with a preoperativebiopsy showing CAEH were compared retrospectively with paraffin block pathology findings.
Results:Paraffin block results were consistent with FS in 78 of 125 patients (62.4%). The FS sensitivity and specificityof detecting cancer were 81.1% and 97.9%, with negative and positive predictive values of 76.7%, and 98.4%,respectively. Paraffin block results were reported as endometrial cancer in 77 of 125 (61.6%) patients. Finalpathology was endometrial cancer in 45.3% patients diagnosed at our center and 76.9% for patients who hadtheir diagnosis at other clinics (p=0.018). Paraffin block results were consistent with FS in 62.4% of all casesConsistence was 98.4% in patients who had endometrial cancer in FS.
Conclusion: FS does not exclude thepossibility of endometrial cancer in patients with the preoperative diagnosis of CAEH. In addition, sufficientendometrial sampling is important for an accurate diagnosis