Accuracy of Frozen Section Biopsy in the Diagnosis of Endometrial Cancer: A Systematic Review and Meta-Analysis
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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/6/1200 |
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| author | Stergios Kopatsaris Aikaterini Apostolopoulou Ioannis Tsakiridis Antigoni Tranidou Fotios Zachomitros Evangelos Papanikolaou Alexandros Daponte Ioannis Kalogiannidis Themistoklis Dagklis |
| author_facet | Stergios Kopatsaris Aikaterini Apostolopoulou Ioannis Tsakiridis Antigoni Tranidou Fotios Zachomitros Evangelos Papanikolaou Alexandros Daponte Ioannis Kalogiannidis Themistoklis Dagklis |
| author_sort | Stergios Kopatsaris |
| collection | DOAJ |
| description | 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, <i>p</i> = 0.399) and Higgins’ I<sup>2</sup> (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. |
| first_indexed | 2024-04-24T18:27:33Z |
| format | Article |
| id | doaj.art-0486586f2f0644fb9de0a8fe11c4375c |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-04-24T18:27:33Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-0486586f2f0644fb9de0a8fe11c4375c2024-03-27T13:30:06ZengMDPI AGCancers2072-66942024-03-01166120010.3390/cancers16061200Accuracy of Frozen Section Biopsy in the Diagnosis of Endometrial Cancer: A Systematic Review and Meta-AnalysisStergios Kopatsaris0Aikaterini Apostolopoulou1Ioannis Tsakiridis2Antigoni Tranidou3Fotios Zachomitros4Evangelos Papanikolaou5Alexandros Daponte6Ioannis Kalogiannidis7Themistoklis Dagklis8Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceLaboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceThird Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceThird Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceThird Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceThird Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceDepartment of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, University of Thessaly, 41110 Larisa, GreeceThird Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceThird Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceThe 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, <i>p</i> = 0.399) and Higgins’ I<sup>2</sup> (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.https://www.mdpi.com/2072-6694/16/6/1200endometrial lesionsendometrial canceratypical hyperplasiafrozen sectiondiagnostic accuracymeta-analysis |
| spellingShingle | Stergios Kopatsaris Aikaterini Apostolopoulou Ioannis Tsakiridis Antigoni Tranidou Fotios Zachomitros Evangelos Papanikolaou Alexandros Daponte Ioannis Kalogiannidis Themistoklis Dagklis Accuracy of Frozen Section Biopsy in the Diagnosis of Endometrial Cancer: A Systematic Review and Meta-Analysis Cancers endometrial lesions endometrial cancer atypical hyperplasia frozen section diagnostic accuracy meta-analysis |
| title | Accuracy of Frozen Section Biopsy in the Diagnosis of Endometrial Cancer: A Systematic Review and Meta-Analysis |
| title_full | Accuracy of Frozen Section Biopsy in the Diagnosis of Endometrial Cancer: A Systematic Review and Meta-Analysis |
| title_fullStr | Accuracy of Frozen Section Biopsy in the Diagnosis of Endometrial Cancer: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Accuracy of Frozen Section Biopsy in the Diagnosis of Endometrial Cancer: A Systematic Review and Meta-Analysis |
| title_short | Accuracy of Frozen Section Biopsy in the Diagnosis of Endometrial Cancer: A Systematic Review and Meta-Analysis |
| title_sort | accuracy of frozen section biopsy in the diagnosis of endometrial cancer a systematic review and meta analysis |
| topic | endometrial lesions endometrial cancer atypical hyperplasia frozen section diagnostic accuracy meta-analysis |
| url | https://www.mdpi.com/2072-6694/16/6/1200 |
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