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目的:快速冷冻切片在骨与软组织肿瘤诊治中的应用价值尚存在争议,因此,有必要进一步探讨其在骨与软组织肿瘤诊治过程中的参考作用。方法:对109例骨与软组织肿瘤行快速冷冻切片病理诊断和常规石蜡切片诊断并比较分析。结果:快速冷冻切片与最终病理完全符合占58.7%(64/109),基本符合占33.0%(36/109),定性诊断占91.7%(100/109);不能确诊或误诊占8.3%(9/109)。15例转移癌中14例诊断符合占93.0%;恶性骨肿瘤手术切缘符合率100.0%(10/10)。109例患者常规石蜡切片病理诊断与最终病理完全符合占85.3%(93/109),基本符合占12.8%(14/109);定性诊断占98.2%(107/109);误诊2例占1.8%,需行免疫组化或外院病理会诊以明确诊断。快速病理及常规病理与最终病理完全符合率比较有显著性统计学差异(P<0.01)。但其在定性诊断的比较无统计学差异(P>0.05)。结论:快速冷冻切片可作为骨与软组织肿瘤诊断的定性参考;高质量的快速冰冻切片,经验丰富的病理医师,临床、影像及病理医师的密切配合是保证快速冷冻切片正确结果的重要条件,在严格掌握其适应证的条件下可作为治疗的参考。
OBJECTIVE: The value of rapid frozen section in the diagnosis and treatment of bone and soft tissue tumors remains controversial. Therefore, it is necessary to further explore its reference role in the diagnosis and treatment of bone and soft tissue tumors. Methods: 109 cases of bone and soft tissue tumors were examined by rapid frozen section and routine paraffin sections. Results: FTIR was consistent with the final pathology in 58.7% (64/109), accounting for 33.0% (36/109), 91.7% (100/109) in qualitative diagnosis, 8.3% (8.3%) in non-diagnosis or misdiagnosis / 109). Of the 15 cases with metastatic carcinoma, 14 cases were diagnosed as 93.0%, while those with malignant bone tumors were 100.0% (10/10). The histopathological diagnosis and pathology of the paraffin sections of 109 patients were completely consistent with the final pathology (85.3%, 93/109), accounting for 12.8% (14/109), qualitative diagnosis (98.2%, 107/109), misdiagnosis (1.8%), , The need for immunohistochemistry or pathological consultation outside the hospital to confirm the diagnosis. There was a significant statistical difference between rapid pathology, routine pathology and final pathology (P <0.01). However, there was no statistical difference in the qualitative diagnosis (P> 0.05). Conclusion: The rapid frozen section can be used as a qualitative reference for the diagnosis of bone and soft tissue tumors. The close cooperation of high-quality fast frozen sections, experienced pathologists, clinical, imaging and pathologists is an important condition to ensure the correct results of rapid frozen sections. Strict control of their indications can be used as a reference for treatment.