The early and accurate diagnosis of endometrial cancer is of paramount importance for the survival of these patients. The aim of this study was to systematically appraise the available data regarding the accuracy of frozen section biopsy in diagnosing endometrial cancer. A thorough literature search was performed in PubMed/Medline, Scopus and the Cochrane Central Register of Controlled Trials databases from inception up to January 2023, with the use of specific, relevant key terms. A quality evaluation for each study was performed with the QUADAS-2 tool, whereas a bivariate random-effect model was performed to generate a summary receiver-operated curve. Heterogeneity was evaluated with Cochrane Q and Higgins’ I2 statistics. Subgroup analyses were performed for studies focused on atypical hyperplasia and those focused on endometrial cancer. The search yielded 47 studies, involving 7790 patients with endometrial cancer. Among them, only 11 could be included in the quantitative analysis. QUADAS-2 evaluation resulted in rather high quality among the included studies. Quantitative synthesis resulted in a pooled sensitivity of 0.863 and pooled specificity of 0.916. The AUC was 0.948, the Q statistic was 10.488 (10 df,p= 0.399) and Higgins’ I2(4.655%) reported no significant heterogeneity. Subgroup analyses based on the diagnosis revealed a pooled sensitivity 0.886, specificity 0.862 and AUC 0.934 for endometrial cancer versus a sensitivity of 0.816, specificity of 0.962 and AUC 0.939 for atypical hyperplasia. Frozen section appears as a valid and reliable diagnostic tool for endometrial cancer. Its reliability seems to be even higher for the diagnosis of atypical hyperplasia. Therefore, this method may be considered in clinical practice and in settings with appropriate resources.
子宫内膜癌的早期准确诊断对患者生存至关重要。本研究旨在系统评估冰冻切片活检诊断子宫内膜癌的准确性。通过使用特定关键词，对PubMed/Medline、Scopus和Cochrane Central Register of Controlled Trials数据库自建库至2023年1月的文献进行全面检索。采用QUADAS-2工具进行质量评估，并运用双变量随机效应模型生成综合受试者工作特征曲线。通过Cochrane Q检验和Higgins I²统计量评估异质性，同时针对非典型增生和子宫内膜癌研究进行亚组分析。最终纳入47项涉及7790例子宫内膜癌患者的研究，其中11项符合定量分析条件。QUADAS-2评估显示纳入研究质量较高。定量综合结果显示：合并敏感度为0.863，合并特异度为0.916，曲线下面积为0.948。Q统计量为10.488（自由度10，p=0.399），Higgins I²（4.655%）显示无异质性。亚组分析显示：子宫内膜癌诊断的合并敏感度0.886、特异度0.862、曲线下面积0.934；非典型增生诊断的敏感度0.816、特异度0.962、曲线下面积0.939。研究表明冰冻切片是诊断子宫内膜癌的有效可靠方法，在非典型增生诊断中表现更优，建议在具备相应资源的临床实践中推广应用。
肿瘤(癌症)患者之家