Publication: The Diagnostic Accuracy of Frozen Section Compared to Permanent Section: Single Center Study
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Intra-operative consultation by frozen section is a procedure which plays a major
role in the surgical management of patients with neoplastic and non neoplastic
disease. Therefore it is critical to determine efficiency of frozen section performance
periodically.
Objective
To evaluate the accuracy of frozen section tests at different anatomical sites by
comparing the frozen section diagnosis with the histological diagnosis.
Method
We conducted a retrospective study in Dhulikhel Hospital, Kathmandu University
Hospital, Dhulikhel, and compared the results of 47 cases of frozen section with their
final permanent section diagnosis during a period of January 2017 to December
2018.
Result
A total of 47 cases were studied on frozen section while no case was deferred for
permanent paraffin section. The indication of frozen section was for presence/
typing of neoplasm in 38 cases (80.75%), clearance of margin in eight cases (17%)
and diagnosis of Hirschsprung’s disease in one case (2.1%). The overall accuracy
of frozen section was 91.4% (43 cases) with 8.5% (four cases) discordant with the
diagnosis, reported as false negative. None of the cases were reported as false
positive. Sensitivity, specificity, positive predictive value and negative predictive
value of frozen section in comparison with permanent section (as gold standard)
were 85.18%, 100%, 100% and 83.33% respectively.
Conclusion
The accuracy of frozen section diagnosis at our institute was 91.4% which can be
interpreted as comparable with most national and international studies. The overall
error rate is 8.5% which is higher than previously published studies. Experience and
training of the pathologist reduce the error rate.
KEY WORDS
Accuracy, Discordant, Deferred, Frozen section, Intra-operative consultation,
Permanent section
Description
Dhakal B, Makaju R
Department of Pathology
Kathmandu University School of Medical Sciences
Dhulikhel, Kavre, Nepal
Keywords
Accuracy, Discordant, Deferred, Frozen section, Intra-operative consultation, Permanent section