Intra-Operative Frozen Sections: Experience at A Tertiary Care Centre

Abstract

<br /> <span style="font-size: small;">The present study was conducted to assess error rates with diagnosis using intra-operative frozen sections, and to indicate ways to increase overall performance. Over a period of two years, 227 cases were biopsied intra-operatively. Errors were observed in 14 cases. Four of these were sampling errors, one by a pathologist and three by surgeons. In </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">seven cases incorrect interpretations were made. Epithelial dysplasia was observed on definitive histology in two cases </span></span><span style="font-size: small;">which was not reported intra-operatively. One case was of ectopic thyroid. In cases of oral cancer where sentinel lymph </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">nodes were sampled, immunohistochemistry for cytokeratin was performed to facilitate identification of micrometastasis. </span></span><span style="font-size: small;">Only single case displayed tumor deposits which was not evident morphologically. Resection margins were reported </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">in seventy eight cases. Some 18% (14/50) benefited from revision of margins; overall sensitivity of intra-operative frozen sections for marginal status was 71.4%, with a specificity of 90.3%. Overall sensitivity was 75% and specificity </span></span><span style="font-size: small;">was 97.5%. Careful observation, pathologist experience and knowledge of limitations help in improving the overall diagnostic outcome. </span>