{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T15:52:17Z","timestamp":1790092337620,"version":"4.0.1"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T00:00:00Z","timestamp":1635984000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T00:00:00Z","timestamp":1635984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cancer"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Surgeons sometimes have difficulty determining which result to favor when preoperative results (MRI\u2009+\u2009preoperative endometrial biopsy [pre-op EB]) differ from intraoperative frozen section histology (FS) results. Investigation of how FS can complement ordinary preoperative examinations like MRI and pre-op EB in identification of patients at high risk of lymph node metastasis (high-risk patients) could provide clarity on this issue. Therefore, the aim of this study is to assess the utility of pre-op EB, MRI and FS results and determine how to combine these results in identification of high-risk patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The subjects were 172 patients with endometrial cancer. Patients with a histological high-grade tumor (HGT), namely, grade 3 endometrioid cancer, clear cell carcinoma or serous cell carcinoma, or with any type of cancer invading at least half of the uterine myometrium were considered high-risk. Tumors invading at least half of the uterine myometrium were classified as high-stage tumors (HST). We compared <jats:italic>(a)<\/jats:italic> detection of HGT using pre-op EB versus FS, <jats:italic>(b)<\/jats:italic> detection of HST using MRI versus FS, and <jats:italic>(c)<\/jats:italic> identification of high-risk patients using MRI\u2009+\u2009pre-op EB versus FS. Lastly, we determined to what degree addition of FS results improves identification of high-risk patients by routine MRI\u2009+\u2009pre-op EB.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p><jats:italic>(a)<\/jats:italic> Sensitivity, specificity, and accuracy for detecting HGT were 59.6, 98.4 and 87.8% for pre-op EB versus 55.3, 99.2 and 87.2% for FS (<jats:italic>P<\/jats:italic>\u2009=\u20090.44). <jats:italic>(b)<\/jats:italic> These figures for detecting HST were 74.4, 83.0 and 80.8% for MRI versus 46.5, 99.2 and 86.0% for FS (<jats:italic>P<\/jats:italic> &lt; 0.001). <jats:italic>(c)<\/jats:italic> These figures for identifying high-risk patients were 78.3, 85.4 and 82.6% for MRI\u2009+\u2009pre-op EB versus 55.1, 99.0 and 81.2% for FS (<jats:italic>P<\/jats:italic> &lt; 0.001). The high specificity of FS improved the sensitivity of MRI\u2009+\u2009pre-op EB from 78.3 to 81.2%, but this difference was not statistically significant (<jats:italic>P<\/jats:italic> &lt; 0.16).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Frozen section enables identification of high-risk patients with nearly 100% specificity. This advantage can be used to improve sensitivity for identification of high-risk patients by routine MRI\u2009+\u2009pre-op EB, although this improvement is not statistically significant.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12885-021-08910-5","type":"journal-article","created":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T17:02:44Z","timestamp":1636045364000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Can addition of frozen section analysis to preoperative endometrial biopsy and MRI improve identification of high-risk endometrial cancer patients?"],"prefix":"10.1186","volume":"21","author":[{"given":"Go","family":"Nakai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshikazu","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahide","family":"Ohmichi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keigo","family":"Osuga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,4]]},"reference":[{"key":"8910_CR1","doi-asserted-by":"publisher","first-page":"CD007585","DOI":"10.1002\/14651858.CD007585.pub3","volume":"9","author":"JA Frost","year":"2015","unstructured":"Frost JA, Webster KE, Bryant A, Morrison J. 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