Correlation of intraoperative frozen section report and histopathological diagnosis: a two-year retrospective study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20252394Keywords:
Benign, Diagnostic accuracy, Frozen section, Haematoxylin eosin staining, Histopathology, MalignantAbstract
Background: Frozen section is an intraoperative pathological technique which has very important role to play in diagnostics and also it plays important role in further surgical management as specially in oncology setup. The present study was undertaken to assess the degree of diagnostic accuracy of frozen section examination of various anatomical sites, overall accuracy, sensitivity and specificity of frozen section technique.
Methods: During the study period from 1st May 2021 to 30th April 2023, a total of 70 patients underwent surgery with intraoperative pathologic consultation for various malignant and non-malignant conditions were reviewed. For frozen section, fresh tissue was sent from the operation theatre to Pathology department and the gross specimens were inspected, dissected and blocks were cut on the cryostat (Leica CM 1950) using Optimal cooling temperature (OCT) compound as embedding medium followed by rapid Haematoxylin-Eosin staining.
Results: The most common indications for frozen section encountered in our institute were Sentinel/Locoregional lymph node (57%). Highest number cases were from lymph node (40) followed by thyroid (12), breast tissue (6) etc. Overall diagnostic accuracy of frozen section was 95.7% (67/70 cases). Concordance rate was 95.7% (67 cases), sensitivity 93.9% and specificity 97.2% with positive predictive value 96.7% and negative predictive value 94.7%. Conclusions: Frozen section is the mainstay of rapid diagnosis in histopathology. It is an accurate and reliable method when it is used for suspicious malignancies, tumor resection margin, metastasis of lymph nodes and identification of tissue. It is chiefly performed to determine whether tissue being sampled is malignant or benign.
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References
Patil P, Shukla S, Bhake A, Hiwale K. Accuracy of frozen section analysis in correlation with surgical pathology diagnosis. Int J Res Med Sci. 2015;3:399-404. DOI: https://doi.org/10.5455/2320-6012.ijrms20150203
El Bahrawy M, Ganesn R. Frozen section in gynaecology : uses and limitations. Arch Gynecol Obstet. 2014;289(6):1165–70. DOI: https://doi.org/10.1007/s00404-013-3135-y
Jaafar H. Intra-operative frozen section consultation: concepts, applications and limitations. Malays J Med Sci. 2006;13(1):4-12.
Maurya VP, Rana V, Kulhari K, Kumar P, Takkar P, Singh N. Analysis of intraoperative frozen section consultations and audit of accuracy: a two yearexperience in a tertiary care multispecialtyhospital in India.Int J Res Med Sci 2020;8:2782-90. DOI: https://doi.org/10.18203/2320-6012.ijrms20203042
Raab SS, Tworek JA, Souers R, Zarbo RJ. The value of monitoring frozen section-permanent section correlation data over time. Arch Pathol Lab Med. 2006;130(3):337-42. DOI: https://doi.org/10.5858/2006-130-337-TVOMFS
Bharadwaj BS, Deka M, Salvi M, Das BK, Goswami BC. Frozen section versus permanent section in cancer diagnosis: a single centre study. Asian Pac J Cancer Care. 2022;7(2):247-51. DOI: https://doi.org/10.31557/apjcc.2022.7.2.247-251
Shah HS, Daveshwar MR, Rana NA. Correlation of intraoperative frozen section report and histopathological diagnosis. MedPulse International J Pathol. 2019;12(3):897. DOI: https://doi.org/10.26611/1051239
Adhikari P, Upadhyaya P, Karki S, Agrawal CS, Chettri ST, Agrawal A. Accuracy of Frozen Section with Histopathological Report in an Institute. JNMA J Nepal Med Assoc. 2018;56(210):572-7. DOI: https://doi.org/10.31729/jnma.3545
White VA, Trotter MJ. Quality assurance in anatomic pathology: Correlation of intraoperative consultation with final diagnosis in 2812 specimens. Abstract presented at the 96th annual meeting of the United States and Canadian Academy of Pathology. 2007.
Ahmad Z, Barakzai MB, Idrees R, Bhurgri Y. Correlation of intra-operative frozen section consultation with the final diagnosis at a referral center in Karachi, Pakistan. Indian J Pathol Microbiol. 2008;51(4):469-473. DOI: https://doi.org/10.4103/0377-4929.43733
Hatami H, Mohsenifar Z, Alavi S. The Diagnostic Accuracy of Frozen Section Compared to Permanent Section: A Single Center Study in Iran. Iran J Pathol. 2015;10(4):295-9.
Mahe E, Ara S, Bishara M, Kurian A, Tauqir S, Ursani N, et al. Intraoperative pathology consultation: error, cause and impact. Canadian J Surg. 2013;56(3):13-8. DOI: https://doi.org/10.1503/cjs.011112
Preeti A, Sameer G, Kulranjan S, Arun Abhinav S, Preeti R, Sunita Y, et al. Intra-Operative Frozen Sections: Experience at A Tertiary Care Centre. Asian Pacific J Canc Prev. 2016;17(12):5057-61.
Ayyagari S, Potnuru A, Saleem SA, Marapaka P. Analysis of frozen section compared to permanent section: A 2 years study in a single tertiary care hospital. J Pathol Nep. 2021;12(2):1854-8. DOI: https://doi.org/10.3126/jpn.v11i2.37681
Nikhra P, Gupta K, Bambora Q, Maheshwari V. Comparative study of frozen section with permanent section at a tertiary care centre in southern Rajasthan. Int J Cur Res Rev. 2021;13(1):103-6. DOI: https://doi.org/10.31782/IJCRR.2021.13135
Dhakal B, Makaju R. The diagnostic accuracy of frozen section compared to permanent section: single center study. Kathmandu Univ Med J. 2019;67(3):229-33.