Analysis of frozen section in correlation with surgical pathology diagnosis
DOI:
https://doi.org/10.18203/2320-6012.ijrms20192519Keywords:
Accuracy, Conventional histopathology, Frozen section, Intra-operative consultationAbstract
Background: Frozen section (FS) is a rapid diagnostic procedure performed on tissues obtained intraoperatively. This method serves useful purposes, such as determining the malignancy or benignancy of a suspected lesion, determining the adequacy of a biopsy of a suspected lesion, confirming the presence or absence of metastasis, and identifying small structures. But it bears many disadvantages and limitations, the most of which is the danger of incorrect diagnosis. Therefore, it is critical to determine efficiency of frozen section performance periodically. This study was performed to determine accuracy of frozen section by correlating the intra-operative frozen section diagnosis with final diagnosis on permanent sections.
Methods: In this retrospective study, authors compared the results of frozen section with their final permanent section diagnosis in Government Medical College and Hospital, Aurangabad, Maharashtra, India during January 2017 to December 2018.
Results: Study comprises 83 patients, of which 73 were female and 10 were male. Out of 83 cases, the diagnosis of 76 cases was concordant with conventional histopathology diagnosis while seven were discordant. This gave overall accuracy rate of 91.57% and discordant rate of 8.43%. The overall sensitivity was 85.71% and specificity was 97.92%. The positive predictive and negative predictive value was 96.77% and 90.38% respectively.
Conclusions: The accuracy, sensitivity, specificity of frozen section diagnosis in this study are comparable with most international quality control statistics for frozen sections. The results suggest that the correlation of intra-operative frozen section diagnosis with the final histopathological diagnosis on permanent sections forms an integral part of quality assurance activities in the surgical pathology laboratory and specific measures should be taken to reduce the number of discrepancies.
References
Jeong HJ, Lee KK, Choi IJ. Frozen Section: Indications, limitations, and accuracy. Korean J Pathol. 1985;19(1):45-50.
Jaafar H. Intra-operative frozen section consultation: concepts, applications and limitations. Malays J Med Sci. 2006;13(1):4-12.
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.
Chang JL, Tseng HH, Sheu LF, Lee WH, Tu YC. Diagnostic accuracy of frozen sections in surgical pathology-a retrospective analysis of 1084 frozen sections. J Med Sci. 1992;13(2):133-42.
Farah-Klibi F, Neji O, Ferjaoui M, Zaouche A, Koubaa A, Sfar R, et al. Accuracy of frozen section diagnosis: an analysis of 1695 consecutive cases. Tunis Med. 2008;86(7):693-7.
Shrestha S, Lee MC, Dhakal H, Pun CB, Pradhan M, Shrestha S, et al. Comparative Study of Frozen Section Diagnoses with Histopathology. Postgraduate Med J NAMS. 2009;3(2):1-5.
Abbasi F, Yekta Z, Aryan A. Accuracy of Frozen Sections. Iranian J Pathol. 2012;7(1):3-8.
Howanitz PJ, Hoffman GG, Zarbo RJ. The accuracy of frozen-section diagnoses in 34 hospitals. Arch Pathol Lab Med. 1990;114(4):355-9.
Chandramouleeswari K, Yogambal M, Arunalatha P, Bose JC, Rajendran A. Frozen and paraffin sections- Comparative study highlighting the concordance and discordance rates in a tertiary care centre. IOSR J Dental Med Sci. 2013;12(5):26-30.
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.
Ackerman LV, Ramirez GA. The indications for and limitations of frozen section diagnosis. A review of 1269 consecutive frozen section diagnoses. Br J Surg. 1959;46(198):336-50.
Susan C. Lester. Operating Room Consultations. Manual of Surgical Pathology. Philadelphia: Churchill Livingstone, 2001:39-40.
Zarbo RJ, Hoffman GG, Howanitz PJ. Interinstitutional comparison of frozen . section consultation: A College of American Pathologists Q-Probe study of 79,647 consultations in 297 North American institutions. Arch Pathol Lab Med. 1991;115:1187-94.
Novis DA, Gephardt GN, Zarbo RJ. College of American Pathologists. Interinstitutional comparison of frozen section consultation in small hospitals: A College of American Pathologists Q-probes study of 18,532 frozen section consultation diagnoses in 233 small hospitals. Arch Pathol Lab Med. 1996;120(12):1087-93.
Ahmad Z, Barakzai MA, 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.
