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    Are preoperative features effective in the incompatibility of intraoperative frozen section and final pathology in operated patients diagnosed with atypia endometrial hyperplasia?
    (Rabia YILMAZ, 2023) Görgülü, Gökşen; Özdaş, Emel Doğan; Özdaş, Erol; Tunalı, Çağdaş; Dinçer, Fatih; Erdoğan, Özgür; Akdemir, Celal
    ABSTRACT Objective: We aim to investigate the relationship between demographic characteristics and preoperative laboratory findings with the discordance between intraoperative frozen section diagnoses and final diagnoses in patients undergoing surgery with endometrial hyperplasia with atypia. Methods: The study included 154 patients who underwent surgery for endometrial hyperplasia with atypia and who received intraoperative frozen section (IFS) diagnosis between January 2015 and January 2021. Frozen section diagnoses and the final diagnoses of the patients were compared. Patient groups were split into two: patients with an IFS diagnosis concordant and patients with an IFS diagnosis discordant with the final diagnosis. These two groups were compared regarding body mass index (BMI), age, systemic diseases, laboratory parameters and ultrasonography findings. Results: When final diagnoses and IFS diagnoses were contrasted, the results were concordant in 126 patients and discordant in 28 patients. The agreement rate was 81.8% (Kappa = 0.635; p < 0.001; significant agreement). When the concordant and discordant groups were compared regarding demographic characteristics and preoperative laboratory findings, it was found that the BMI was higher, and the rate of complex atypia in the preoperative pathological examination was higher in the discordant group (p < 0.05). Other inflammatory markers and demographic variables were not significantly different between groups (p > 0.05). Conclusion: Among patients operated for endometrial hyperplasia with atypia, IFS diagnoses were mostly concordant with the final diagnoses. It should be kept in mind that the discordance rate may be higher in atypical hyperplasias with complex structure and in patients with high BMI.
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    IS PRE-OPERATIVE BLOCK CONSULTATION NECESSARY IN ATYPICAL ENDOMETRIAL HYPERPLASIA?
    (2023) Görgülü, Gökşen; Özdaş, Emel Doğan; Özdaş, Erol; Tunalı, Çağdaş; Erdoğan, Özgür; Akdemir, Celal; Bağcı, Mustafa
    Introduction: This study aimed to investigate the need to re-evaluate paraffin block pathology preparations of endometrial biopsy samples taken from patients diagnosed with atypical endometrial hyperplasia (AEH) at different institutions by expert gynaecologic pathologists before surgery at a tertiary hospital. Materials and Methods: This study included 116 patients diagnosed with AEH based on endometrial biopsy samples taken at different institutions between January 2017 and January 2021 and operated on at our clinic. The paraffin blocks of all patient samples included in the study were re-evaluated at the Pathology Department of our hospital (block consultation). Patients were divided into two groups as follows: those diagnosed with AEH based on endometrial biopsy at an external centre (all patients) and those diagnosed with AEH based on paraffin block examination. The post-operative pathology results of the two groups were compared. Results: Block consultation indicated AEH in 77 (66.4%) of the patients with AEH diagnosed at an external centre. Post-operative pathology results revealed that 15 (12.9%) patients had benign, 42 (36.2%) had AEH and 59 (50.9%) had malignant. On comparing the post-operative pathology results of the two groups, no significant difference was observed (p = 0.252). There was no significant difference between the two groups in terms of the grade and stage of the malignancy detected on post-operative pathological evaluation (p = 0.603 and p = 0.552, respectively). Conclusion: Although re-examination of the paraffin blocks of patients diagnosed with AEH based on endometrial biopsy samples taken at di fferent institutions by gynaecologic pathologists (block consultation) led to different results, no significant difference was noted on comparing the post-operative pathology results. To ensure that workload does not increase and to save time, patients diagnosed with AEH based on endometrial biopsy can be operated on without re-examining the paraffin blocks to confirm the diagnosis.