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

Turan, Taner; Karadağ, Burak; Karabük, Emine; Tulunay, Gökhan; Özgül, Nejat; Gültekin, Murat; Boran, Nurettin; Isikdogan, Zuhal; Köse, Mehmet

doi:10.7314/apjcp.2012.13.5.1953

Cited by 16 publications

(17 citation statements)

References 19 publications

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“…Adenocarcinoma of the endometrium is the most common gynecological cancer (Turan et al, 2012). On the basis of this knowledge we aimed to investigate precancerous lesions in obese risky postmenopausal population and we found that ET was statistically thicker in patients with precancerous pathology than patients with normal pathologic results.…”

Section: Discussionmentioning

confidence: 96%

Evaluation of Endometrial Precancerous Lesions in Postmenopausal Obese Women - A High Risk Group?

Açmaz¹,

Aksoy²,

Albayrak³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Aim: To evaluate precancerous lesions such as hyperplasia and endometrial polyps in obese postmenopausal women. Materials and Methods: Women who were referred with abnormal uterine bleeding in postmenopausal period or the presence of endometrial cells on cervical cytology in our department were investigated. Anthropometric measurements such as height, weight, body mass index, waist/hip ratio and endometrial thickness were compared between a precancerous lesion (hyperplasia and endometrial polyp) group and a pathologically normal group. Results: We detected statistically significant thickening of endometrium in patients with precancerous lesions. Moreover patients with precancerous lesions had higher body mass index than the pathologically normal group. Conclusions: We found elevated precancerous lesion rates in overweight and obese women in the postmenopausal period, of interest given that the prevalence of obesity is increasing in most parts of the world. Although screening for endometrial cancer is not recommended for the general population, in high-risk populations like obese postmenopausal women, it may be very important.

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Section: Discussionmentioning

confidence: 96%

Evaluation of Endometrial Precancerous Lesions in Postmenopausal Obese Women - A High Risk Group?

Açmaz¹,

Aksoy²,

Albayrak³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Endometrial carcinoma is the most common gynecologic cancer that is often found in postmenopausal women (Turan et al, 2012). Although uncommon, endometrial polyps may be the potential origine of this malignancy, especially in postmenopausal women (Balik et al, 2012;Acmaz et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Roles of Sonography and Hysteroscopy in the Detection of Premalignant and Malignant Polyps in Women Presenting with Postmenopausal Bleeding and Thickened Endometrium

Cavkaytar

Kokanali²,

Ceran³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: To assess the role of sonographic endometrial thickness and hysteroscopic polyp size in predicting premalignant and malignant polyps in postmenopausal women. Materials and Methods: A total of 328 postmenopausal women with abnormal uterine bleeding and thickened endometrium underwent operative hysteroscopy due to detection of endometrial polyps were included in this retrospective study. Preoperative endometrial thickness measured by transvaginal ultrasonography and polyp size on hysteroscopy were noted. Hysteroscopic resection with histology was performed for endometrial polyps. Endometrial thickness and polyp size were evaluated on the basis of final diagnosis established by histologic examination. Receiver operator characteristic curves were calculated to assess the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of endometrial thickness and polyp size for detecting pemalignant and malignant polyps. Results: Premalignant and malignant polyps were identified in 26 (7.9%) of cases. Sonographic measurement showed a greater endometrial thickness in cases of premalignant and malignant polyps when compared to benign polyps. On surgical hysteroscopy, premalignant and malignant polyps were also larger. Endometrial thickness demonstrated a sensitivity of 53.8%, specificity of 85.8%, PPV of 24.6% and NPV of 95.6% at a cut-off limit of 11.5 mm with diagnostic accuracy of 83.2%. Polyp size has a diagnostic accuracy of 94.8% with a sensitivity of 92.3%, specificity of 95.0%, PPV of 61.5% and NPV of 99.3% at a cut-off point of 19.5mm. Conclusions: Endometrial thickness measured by transvaginal ultrasonography is not sufficient in predicting premalignant and malignant endometrial polyps in postmenopausal women with abnormal uterine bleeding and thickened endometrium. Polyp size on hysteroscopy is a more accurate parameter, because of better sensitivity and specificity. However, while polyp size ≥19.5mm seems to have a great accuracy for predicting premalignancy and malignancy, histologic evaluation is still necessary to exclude premalignant and malignant polyps.

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“…While formaldehyde fixation preserves tissue architecture and allows tissue storage and transport at RT, it also inactivates enzymes and crosslinks proteins necessitating further steps to achieve accurate immunostaining. This problem is eliminated with the use of frozen sections but this method presents unique technical challenges in obtaining optimal staining results and accurate interpretation 14,15 .…”

Section: Discussionmentioning

confidence: 99%

“…Frozen sections, on the other hand, do not need to be pre-fixed or processed; therefore, proteins are able to retain native biological conformations 13,14 . Further, frozen sections also allow for quick turnaround time, which at times is necessary, for example in the intraoperative diagnosis of sarcomas and other surgical biopsies 15 . However, if not done properly, this method is prone to freeze damage, which introduces changes to muscle architecture making the sections unfit for histological examination.…”

Section: Introductionmentioning

confidence: 99%

Do's and Don'ts in the Preparation of Muscle Cryosections for Histological Analysis

Kumar

Accorsi

Rhee

et al. 2015

JoVE

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Histological evaluation of muscle biopsies has served as an indispensable tool in the understanding of the development and progression of pathology of neuromuscular disorders. However, in order to do so, proper care needs to be taken when excising and preserving tissues to achieve optimal staining. One method of tissue preservation involves fixing tissues in formaldehyde and then embedding them with paraffin wax. This method preserves morphology well and allows for long-term storage at RT but is cumbersome and requires handling of toxic chemicals. Further, formaldehyde fixation results in antigen cross-linking, which necessitates antigen retrieval protocols for effective immunostaining. On the contrary, frozen sectioning does not require fixation and thus retains biological antigen conformation. This method also provides a distinct advantage in quick turn around time, making it especially useful in situations needing quick histological evaluation like intraoperative surgical biopsies. Here we describe the most effective method of preparing muscle biopsies for visualization with different histological and immunological stains. Video LinkThe video component of this article can be found at

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

Cited by 16 publications

References 19 publications

Evaluation of Endometrial Precancerous Lesions in Postmenopausal Obese Women - A High Risk Group?

Evaluation of Endometrial Precancerous Lesions in Postmenopausal Obese Women - A High Risk Group?

Roles of Sonography and Hysteroscopy in the Detection of Premalignant and Malignant Polyps in Women Presenting with Postmenopausal Bleeding and Thickened Endometrium

Do's and Don'ts in the Preparation of Muscle Cryosections for Histological Analysis

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