Evaluation of role of intraoperative cytology technique in diagnosis and management of cancer

Abstract

Context: Intraoperative pathological assessment provides valuable information in a patient's diagnosis and management. Touch imprint/crush cytology is simple, rapid, and cost-effective. Also, imprint smears give excellent cytomorphology. Aims: To assess the utility and feasibility of intraoperative cytology technique as a rapid and reliable method for diagnosis and to compare sensitivity, specificity and diagnostic accuracy with histopathology. Materials and Methods: Cytology smears were collected intraoperatively from 52 cases of suspected/proven malignancy. From tumors, surgical margins, lymph nodes; crush, imprint, and scrape smears were prepared. Smears were taken from specimens before formalin fixation and stained with rapid ultrafast Papanicolaou stain. The slides were compared with the histopathology report which is the gold standard. Statistical Analysis: Sensitivity, specificity, and diagnostic accuracy were used for statistical analysis. Results: Intraoperative cytology report could be given in time for the surgeon to modify margins of resection and the extent of lymph node dissection. It helps the surgeon to modify surgery. The diagnostic test evaluation showed satisfactory results. Conclusion: Intraoperative imprint/crush cytology is a simple, inexpensive, rapid, accurate cytodiagnostic technique in the diagnosis of cancer where frozen section facilities are not available. It can also be used to assess the clearance of surgical margins.

Intraoperative cytology when cryostat is not available. A 7‐year experience in a Peruvian cancer center

“…[7][8][9][10][11][12][13] Since Dudgeon and Patrick reported on the cytologic evaluation of tumors in the year 1927, numerous investigators have emphasized the advantages of IC when compared with FS for intraoperative consultations, including rapid turnaround time, simplicity, and equivalent diagnostic accuracy. 1,4,5,[13][14][15][16] Intraoperative cytology preparation methods include, but are not limited to scraping, squashing, spreading, mincing, and imprinting ("touch-preps") of tissue. The appropriate method depends on the size and consistency of the tissue that is sampled.…”

“…Since Dudgeon and Patrick reported on the cytologic evaluation of tumors in the year 1927, numerous investigators have emphasized the advantages of IC when compared with FS for intraoperative consultations, including rapid turnaround time, simplicity, and equivalent diagnostic accuracy 1,4,5,13–16 …”