Exploration of the value of intraoperative frozen sections for excision of eyelid masses and analysis of pathological types
Objective To explore the pathological types of eyelid tumors and their diagnostic accuracy in frozen sections(FS)during inspection,and to analyze the reasons for inconsistencies between FS and paraffin pathology diagnosis.Methods A total of 561 specimens of intraoperative FS eyelid tumor resection in Beijing Tongren Hospital,Capital Medical University from December 2016 to December 2021 were selected.The pathological types of eyelid tumors were analyzed,and the diagnostic accuracy of FS for eyelid tumors and margins was compared with paraffin pathology diagnosis.Results Among the 561 specimens,there were 280 left eyes and 281 right eyes;225 upper lids,311 lower lids,18 medial canthi,and seven lateral canthi.The maximum diameter of the tumors ranged from 1 to 35 mm,with an average of(15.1±9.4)mm.Among them,there were 165 cases of benign lesions(29.4%),with the top three being inflammatory lesions,pigmented nevus and seborrheic keratosis,and 396 cases of malignant lesions(70.6%),with the top three being basal cell carcinoma,sebaceous gland carcinoma and squamous cell carcinoma.The diagnostic accuracy rates of FS for tumor and margin were 97.1%and 99.3%,respectively,and the delayed diagnosis rate of tumor was 6.2%.The types of inconsistent diagnoses included misclassification(60%,9/15),false negative(26.7%,4/15),and false positive(13.3%,2/15).The reasons for inconsistent diagnoses were interpretation errors(73.3%,11/15)and slide preparation errors(26.7%,4/15).Conclusions The majority of FS for eyelid tumors are malignant lesions,most of which are basal cell carcinoma and sebaceous gland carcinoma.FS has a high diagnostic accuracy for eyelid tumor and margins,and can guide the operation well.Special subtypes of malignant tumors and sebaceous gland carcinoma are the main factors of inconsistence with paraffin pathological diagnosis,and insufficient section depth is the main reason for missed diagnosis and inadequate diagnosis.Suspicious recurrence and small tumors should be fully evaluated in daily work.
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