Qualitative Comparative Study of Frozen Section with Routine Histological Technique

Gupta, Meenu; Bharat, Vinay; Bansal, Rani

doi:10.7860/njlm/2016/18786.2111

Cited by 8 publications

(23 citation statements)

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“…In the latter 2 cases, lesion was present in the permanent section of the main specimen. Three cases (0.58%) one each from the ovary, larynx and lymphnode were deferred (Table 3, 4). Sensitivity (true positive/true positive + false negative) of 90.91% and specificity (true negative/true negative + false positive) of 96.59% (Table 4) was obtained.…”

Section: Resultsmentioning

confidence: 96%

“…1 FS is a rapid technique that contributes in the primary diagnosis of a lesion, inflammatory or neoplastic, benign or malignant, status of margins, organ identification and disease extension. 3,4 However the limitations and indications vary according to the individual organs. 3,4 A good rapport with the operating surgeon, better clinical correlation, knowledge about the preoperative and per-operative findings, and limitations of the method helps in getting the maximum yield of the FS.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 However the limitations and indications vary according to the individual organs. 3,4 A good rapport with the operating surgeon, better clinical correlation, knowledge about the preoperative and per-operative findings, and limitations of the method helps in getting the maximum yield of the FS. 1 Errors should be identified and analysed, which can help to carry out appropriate preventive measures.…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative frozen section consultation- an audit in a tertiary care hospital

2020

IJPO

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Introduction: Frozen section (FS) helps the surgeon in the surgical management of the patient by helping in the intraoperative diagnosis of tumors, margins and lymphnode assessment, and organ identification. Audits of the frozen section consultations help in identifying the pitfalls and to carry out appropriate preventive measures for its optimal usage. We report the results of the study of our FS consultations. Materials and Methods: A retrospective study of 518 specimens from 132 consecutive cases of FS consultations was carried out. The FS report and formalin fixed tissue reports were compared and analyzed. The results were categorized into concordant, discordant and deferred consultations. Causes of discrepancy were analysed and diagnostic accuracy, diagnostic error rates, sensitivity, specificity, indications, tissue type, turnaround time and limitations were noted. Results: An average of 3.92 specimens per patient was received with 80(60.61%) males and 52(39.39%) females. Age ranged from 15 to 80 years. Male and female general surgical departments were the major contributors with 64 (48.48%) and 25 (18.94%) consultations respectively. Oropharyngolaryngeal region (48.84%) was the main site sampled. The main indication was margin status assessment (52.27%). Accuracy rate was 98.65% with an error rate of 1.35% was observed. The discordant cases had misinterpretation error in 5 cases and sampling errors in the remaining 2 cases. Three cases (0.58%) were deferred. Sensitivity (90.91%) and specificity (96.59%) was obtained. Conclusions:The study turned out as a quality check and identified the areas requiring improvement to reduce the error rates.

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Section: Resultsmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intraoperative frozen section consultation- an audit in a tertiary care hospital

2020

IJPO

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“…Adequate margin clearance is must as the recurrence is usually aggressive with poorer prognosis. 15 Studies have shown accuracy rate on FS for margin status in oral cancers varying from 71.3% to 97.5%. 3,16 In this study centre no discordant case was reported from oral cavity during the period of audit.…”

Section: Discussionmentioning

confidence: 99%

Analysis of intraoperative frozen section consultations and audit of accuracy: a two year experience in a tertiary care multispeciality hospital in India

Maurya¹,

Rana

Kulhari

et al. 2020

Int J Res Med Sci

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Background: Diagnostic accuracy of intra-operative frozen section (FS) depends largely on quality of tissue sections backed by good clinical communication and experience of reporting pathologist. Periodic audit of this consultation in surgical pathology help in assessing the efficiency of procedure and addressing the pitfalls. In this study authors have analysed the spectrum, indications and assessed the accuracy of FS consultation in their institution.Methods: A retrospective study of 212 consequent tissue specimens submitted for FS over two years in study centre was conducted. The FS and corresponding formalin fixed paraffin embedded (FFPE) tissue section with their final histopathological examination (HPE) reports were studied and analyzed. The results were classified in concordant, discordant and deferred categories. Accuracy rates and discordant frequencies were calculated and comparison with other similar studies was done. Reasons for inaccuracies were deduced.Results: A total of 212 tissue specimens for FS were reported over two years in this study institute, six of which showed discordant results. Most common site of FS in this study centre was from central nervous system (CNS) lesions (28.77%). Indications for intra-operative consultation were mainly for establishment of tumor diagnosis (66.51%) and status of margins (29.25%). The accuracy rate was found to be 97.17% with error rate of 2.83%. On analysis of discordant cases; the reason for inaccuracy was mainly due to interpretation error (83.33%).Conclusions: The audit of FS consultation established that accuracy rates of this study institution are comparable with most international quality control statistics for FS. The discordant cases were mostly false positive hence emphasising that a variable degree of reservation is required while interpreting and communicating the FS results. The closest possible diagnosis should be communicated on FS and definitive diagnosis should be deferred to HPE in case of doubt.

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“…Technical issues leading to alteration in cytological or architectural features necessary for establishing accurate diagnoses during processing of frozen sectioning may pose difficulty. However, use of frozen section with limitations in mind make it a highly sensitive and specific technique playing critical role in management of patients [16].…”

Section: Identification Of Cellmentioning

confidence: 99%

A study on qualitative comparison between cryostat and conventional technique for histopathology diagnosis

Zinzala

Goswami

et al. 2020

Trop J Pathol Microbiol

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Introduction: Intraoperative consultation by frozen section technique is an invaluable tool for immediate diagnosis. The correlation of intraoperative frozen section diagnosis with final diagnosis on permanent section is an integral part of quality assurance in surgical pathology. Its accuracy and limitations vary with different anatomical sites. Aims & Objective: Qualitative morphological comparison between frozen section and routine formalin fixed paraffin embedded sections in different tissues, to assess the accuracy of frozen section, to detect the number and type of discrepancies and to assess the causes for discrepancies. Material and Method: The present study retrospectively reviewed frozen sections performed in the pathology department, Sirt hospital, government medical college, Bhavnagar during a period of 2 year. Diagnostic accuracy of frozen section and its morphological quality and reliability in comparison to histopathology was evaluated by 2 pathologists in a blinded fashion for the following parameters: cellular outline, nuclear and cytoplasmic features, staining pattern and overall morphology. The results were compared to the routine formalin fixed paraffin sections to evaluate diagnostic accuracy. Discordant cases were reassessed to find the reasons for discrepancy. Result: Diagnostic accuracy of frozen section was 95.1% with false negative case are 4.8% and no false positive case. Statistical analysis showed that most common indications of frozen section in the present study was presence/typing of neoplasm (61.2%) followed by assessment of margin (35.6%) and assessment of nodal status (3.2%). It was observed that nuclear details, cellular outline and overall morphological quality of frozen section was slightly inferior to that of routine histopathology section, however, staining and cytoplasmic details were comparable. The discrepancies were mainly due to technical artefacts (9.7%), sampling error (3.2%) interpretation error (1.6%), and partly due to lack of interdepartmental communication. Conclusion: Frozen section diagnosis is very useful and highly accurate procedure. Gross inspection, sampling by pathologist, frozen complemented with cytological and histological review and intimal cooperation with surgeon can avoid certain limitations and provide rapid, reliable, cost effective information necessary for optimum patient care.

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Qualitative Comparative Study of Frozen Section with Routine Histological Technique

Cited by 8 publications

References 0 publications

Intraoperative frozen section consultation- an audit in a tertiary care hospital

Intraoperative frozen section consultation- an audit in a tertiary care hospital

Analysis of intraoperative frozen section consultations and audit of accuracy: a two year experience in a tertiary care multispeciality hospital in India

A study on qualitative comparison between cryostat and conventional technique for histopathology diagnosis

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