Introduction: With around 25 different salivary gland tumor entities described by the World Health Organization, the correct preoperative identification of masses as benign or malignant remains a challenge. If preoperative needle biopsy is inconclusive, frozen section analysis is a possible alternative for accurate histological identification. The purpose of our study was to evaluate the diagnostic effectiveness of frozen section performed for primary submandibular gland masses.Methods: In addition to acquiring epidemiological data from patients who underwent submandibular gland excision over a 20-year period, we analyzed the diagnostic effectiveness of frozen section performed for submandibular gland masses. We also examined the impact of frozen section on overall survival. Furthermore, we investigated whether there was an impact on the surgical revision rate for malignant submandibular gland masses that required additional neck dissection within the submandibular triangle.Results: Frozen section was performed for 54 submandibular gland tumors, with a specificity of 100% and a sensitivity of 81.3%. Frozen section was conducted in 12 cases of primary salivary gland malignancies, of which 9 cases were identified correctly. In three cases, the frozen section results were inconclusive. We calculated a relative risk reduction of 27% for revision surgery by performing frozen section. There was no significant association between frozen section results and overall survival.Conclusions: Frozen section demonstrates a significant reduction in the need for revision surgery. With a specificity of 100%, frozen section is especially suited to identifying benign masses. It is a valid diagnostic tool when preoperative sampling is not possible or is inconclusive.
引言：世界卫生组织描述了约25种不同的唾液腺肿瘤类型，术前准确鉴别肿块良恶性仍具挑战性。若术前穿刺活检结果不明确，术中冰冻切片分析可作为实现精确组织学鉴别的替代方案。本研究旨在评估针对原发性颌下腺肿块实施冰冻切片的诊断效能。 方法：通过收集20年间接受颌下腺切除术患者的流行病学数据，我们系统分析了针对颌下腺肿块实施冰冻切片的诊断效能，并评估了该技术对患者总生存期的影响。同时，针对需要额外行颌下三角区颈清扫术的恶性颌下腺肿瘤病例，我们进一步探究了冰冻切片对二次手术率的影响。 结果：54例颌下腺肿瘤接受了冰冻切片检查，其诊断特异性达100%，敏感性为81.3%。在12例原发性唾液腺恶性肿瘤中，9例通过冰冻切片获得正确诊断，3例结果不明确。统计分析显示，实施冰冻切片可使二次手术的相对风险降低27%。冰冻切片结果与患者总生存期无显著相关性。 结论：冰冻切片能显著降低二次手术需求。该技术具有100%的特异性，尤其适用于良性肿块的鉴别诊断。当术前无法获取有效样本或活检结果不明确时，冰冻切片是一种有效的诊断工具。
Frozen Section Analysis in Submandibular Gland Tumors: Optimizing Intraoperative Decision-Making
肿瘤(癌症)患者之家