Diagnostic Value of Frozen Section in Endometrial Curetting Compared to Permanent Pathology

Abstract

Background: Frozen section is widely used in gynecological oncology. However, the accuracy of frozen section procedure in intraoperative diagnosis of endometrial hyperplasia and endometrial adenocarcinoma in endometrial curettings has not been studied. The aim of this study was determining the accuracy of frozen section in evaluation of histopathologic findings of endometrial curettings from peri- and postmenopausal women with abnormal uterine bleeding (AUB). Methods: 71 women having 45 years or more with the complaint of AUB entered the study. In pathology lab, part of fresh diagnostic sample was prepared for frozen section and the remainder was fixed and further processed for permanent pathology. Permanent pathology was considered as the gold standard for evaluation of histopathologic findings. χ2 and Fisher’s exact tests were used for statistical analysis. Finding: The findings of frozen section were exactly the same as permanent pathology in 70 persent of patients. Despite high specificity of frozen section in detecting various histopathologic findings, significant statistical difference was seen between frozen section and permanent pathology in all of these findings. Conclusion: Our results are in favor of the superiority of permanent pathology over frozen section in evaluation of endometrial curettings. However, according to high specificity of frozen section examination in detecting endometrial hyperplasia and adenocarcinoma, it may be acceptable to rely on the results of frozen section in these conditions to make an intraoperative decision for the type and extent of surgery.

Keywords

• Abnormal uterine bleeding
• Postmenopause
• Frozen sections
• Endometrial hyperplasia
• Endometrial adenocarcinoma