文章：

肺腺癌肿瘤经空气播散冷冻切片诊断效能影响因素分析

Analysis of Factors Affecting the Diagnostic Efficacy of Frozen Sections for Tumor Spread Through Air Spaces in Lung Adenocarcinoma

原文发布日期：27 June 2025

DOI: 10.3390/cancers17132168

类型: Article

开放获取: 是

英文摘要：

Objectives: This study aimed to determine the factors affecting the diagnostic efficacy of frozen sections for assessing tumor spread through air spaces (STAS) and to provide suggestions for the sampling of these frozen sections.Methods: Cases of invasive adenocarcinoma with a pathological diagnosis of stage IA-IIIB were screened, and frozen and paraffin sections were reviewed. Using paraffin sections as the gold standard, the consistency of frozen pathological diagnosis of STAS was calculated. Factors that may affect STAS diagnosis in frozen sections were screened, and a nomogram was drawn.Results: The sensitivity of frozen sections in STAS diagnosis was 55.4% (108/195), the specificity was 74.5% (254/321), and the kappa value was 0.35. In the subsequent logistic regression, the ratio of the tissue diameters of the frozen and paraffin sections, number of frozen section sheets, clarity of the tumor boundary, and number of alveoli from the peritumoral area to tissue edge were all statistically significantly significant (p< 0.05) factors affecting the frozen STAS diagnostic efficacy.Conclusions: The diagnostic efficacy of frozen sections for STAS is poor. In our study, the tissue diameter ratio of the frozen to paraffin sections, the number of frozen sections, the clarity of the tumor boundary, and the number of alveoli from the peritumoral tissue to the tissue edge were considered independent factors affecting diagnostic consistency. The accuracy of the frozen section analysis in STAS diagnosis can be improved by our reasonable suggestions on frozen sampling, making it a reliable indicator of the surgical method.

摘要翻译： 

目的：本研究旨在明确影响冰冻切片评估肿瘤气腔播散诊断效能的因素，并为冰冻切片取样提供建议。方法：筛选病理诊断为IA-IIIB期浸润性腺癌病例，回顾性分析其冰冻切片与石蜡切片结果。以石蜡切片为金标准，计算冰冻病理诊断STAS的一致性。筛选可能影响冰冻切片STAS诊断的因素，并绘制列线图。结果：冰冻切片诊断STAS的敏感性为55.4%（108/195），特异性为74.5%（254/321），Kappa值为0.35。在后续逻辑回归分析中，冰冻与石蜡切片组织直径比值、冰冻切片张数、肿瘤边界清晰度以及瘤周区域至组织边缘的肺泡数量均为影响冰冻切片STAS诊断效能的统计学显著因素（p<0.05）。结论：冰冻切片对STAS的诊断效能较差。本研究发现，冰冻与石蜡切片组织直径比值、冰冻切片张数、肿瘤边界清晰度及瘤周组织至组织边缘的肺泡数量是影响诊断一致性的独立因素。通过我们对冰冻取样的合理建议，可提高冰冻切片分析在STAS诊断中的准确性，使其成为手术方式的可靠指标。

原文链接：

Analysis of Factors Affecting the Diagnostic Efficacy of Frozen Sections for Tumor Spread Through Air Spaces in Lung Adenocarcinoma