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 ≥10) or tumor marker level of serum(CA-125 level≥35U/ml in postmenopause and ≥65U/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 (≥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 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.
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