Analysis of diagnosis accuracy of frozen sections in 73 cases of borderline tumor of ovary / 中华病理学杂志

<p><b>OBJECTIVE</b>To assess the sensitivity and positive predictive value (PPV) of intraoperative frozen section diagnosis of the borderline tumor of ovary (BTO).</p><p><b>METHODS</b>A retrospective analysis and comparison were done respectively between the accuracies of diagnoses made by using frozen and paraffin sections from the same tissue blocks for BTO from March 1995 to May 2008 achieved in the Department of Pathology, Guangdong General Hospital. Univariate and multivariate regression models were used to assess the influence of patient and tumor characteristics on the likelihood of underdiagnosis and overdiagnosis.</p><p><b>RESULTS</b>Of the 73 patients analyzed, 39 cases (53.42%) were histologically serous tumors, 32 (43.84%) were mucinous and 2 (2.74%) were endometrioid tumors. Diagnoses identical in those made by using either frozen or routine paraffin sections were 55/73 (75.34%). The sensitivity and positive predictive value of frozen section diagnosis were 87.30% and 85.94%, respectively. Underdiagnosis of frozen section were 18/73 (24.66%). There was no overdiagnosis cases obtained. Univariate analysis showed that tumor diameter and tumor histology were the predictors of underdiagnosis in frozen section analysis. And in multivariate analysis, only tumor diameter, rather than patient age, tumor histology and stage, bilateral side tumor, serum CA-125 and concurrent presence of endometriosis was a predictor of underdiagnosis.</p><p><b>CONCLUSIONS</b>Intraoperative frozen section diagnosis of BTO has a low sensitivity and PPV. Underdiagnosis is not uncommon. Surgical management based on intraoperative frozen section diagnosis should be used with caution.</p>

Significance of high-risk human papillomavirus DNA in atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore significance of high-risk human papillomavirus (HR-HPV) testing in atypical squamous cells, cannot exclude high grade squamous intraepithelial lesion (ASC-H).</p><p><b>METHODS</b>Presence of HR-HPV DNA was examined in 45 patients with ASC-H using hybrid capture II (HC-II) test. Colposcopic examination and biopsy were taken all results were evaluated.</p><p><b>RESULTS</b>Overall, 33 of 45 (73.3%) ASC-H cases were biopsy proven cervical intraepithelial lesion (CIN). 36 of 45 ASC-H cases were HPV-DNA positive, including 19 cases of HSIL and over lesion; whereas no HSIL or over was found in 9 HR-HPV negative cases. Sensitivity and negativity predictive value of HR-HPV in ASC-H with HSIL and over lesion were both 100%.</p><p><b>CONCLUSIONS</b>ASC-H strongly predicts the presence of HSIL, HR-HPV may serve as a predict select whether a patient with ASC-H should take colposcopic examination immediately, patients with positive HR-HPV should undergo immediate colposcopic examination, while negative HR-HPV is an excellent predictor of the absence of HSIL.</p>

Mesorectal metastasis of middle and lower rectal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To detect mesorectal metastasis of middle and lower rectal cancer and to evaluate its relationship with clinicopathologic characteristics.</p><p><b>METHODS</b>Cancer specimens resected from 56 patients with middle and lower rectal cancer who received total mesorectal excision were examined by routine pathologic observation. The relationship between mesorectal metastasis and clinicopathologic characteristics of middle and lower rectal cancer was also investigated.</p><p><b>RESULTS</b>Mesorectal metastasis was detected in 36 (64.3%) of 56 cancer specimens. In 18 cancer specimens with tumor diameter > or = 5 cm, 15 (83.3%) were detected mesorectal metastasis, while in 38 cancer specimens with tumor diameter < 5 cm only 21 (55.3%) were detected mesorectal metastasis (P = 0.041). Mesorectal metastasis was more frequent in T(3) cancer specimens (81.5%) and T(2) cancer specimens (56.6%), compared with T(1) cancer specimens (1/6) (P = 0.007). 85.7% poorly differentiated cancer specimens were detected mesorectal metastasis, while moderate and well-differentiated cancer specimens were only 63.2% and 1/5 respectively (P = 0.028). Mesorectal metastasis was more frequent in stage III cancer specimens (100%), compared with stage II and I cancer specimens (27.3% and 1/5 respectively, P = 0.000). No significant correlations were found between mesorectal metastasis and other variables such as age, gender and Ming classification (P > 0.05).</p><p><b>CONCLUSION</b>Mesorectal metastasis of middle and lower rectal cancer has significant correlation with tumor diameter, tumor invasion, tumor differentiation and TNM stage. Total mesorectal excision or > or = 5 cm mesorectal distal to the rectal tumor should be followed in the management of middle and lower rectal cancer.</p>

Matrix metalloproteinase-2 expression and its correlation with mesorectal metastasis in middle and lower rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To examine the expression of matrix metalloproteinase-2 (MMP-2) and to evaluate its correlation with mesorectal metastasis in middle and lower rectal cancer.</p><p><b>METHODS</b>The resected primary tumors from 56 patients with middle and lower rectal cancer who received total mesorectal excision were studied from Dec. 2001 to Jul. 2003.</p><p><b>RESULTS</b>The MMP-2 expression was positive in 42 (75%) cases. The positive rate of MMP-2 expression was 88.9% in T3 tumors and 69.6 % in T2 tumors respectively, while only 33.3% in T1 tumors (P=0.013). MMP-2 was positive in 91.2% (31/34) infiltrative rectal carcinomas while 40.0% (6/15) expansive rectal carcinomas (P=0.001). Mesorectal metastasis was detected in 36 (64.3%) of 56 cases. The expression of MMP-2 was positive in 31 (86.1%) of the 36 patients with mesorectal metastasis, while in 11(55%) of the 20 patients without mesorectal metastasis (P=0.01).</p><p><b>CONCLUSIONS</b>The expression of MMP-2 in middle and lower rectal cancer is significantly associated with depth of tumor invasion and Ming classifications. The high expression of MMP-2 may play an important role in the development of mesorectal metastasis in middle and lower rectal cancer.</p>