TITLE:
Accuracy of Intraoperative Frozen Section in the Diagnosis of Ovarian Neoplasms
AUTHORS:
Amany M. Abdelghany, Essa M. Arafa, Nadia M. Madkour, Wael S. Nossair, Ekramy A. Mohamed, Walid A. Abdelsalam, Amira A. Salem
KEYWORDS:
Intraoperative, Frozen Section, Ovarian Neoplasms
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.5 No.1,
January
4,
2015
ABSTRACT: Objective: The aim of the work is to evaluate the accuracy of
intraoperative frozen section in the diagnosis of ovarian neoplasms in Zagazig
University. Design: A prospective cross sectional cohort study. Method: This
study was performed between March 2011 and March 2012, on 50 patients presented
with ovarian mass. Gross examination of the tumor removed was done by
inspection and palpation. The specimen was then cut with a sharp knife into two
halves. The most appropriate area thought to be representative of lesion was
chosen. The number of sections frozen was depended on the type and size of the
tumor. Seven to eight μm sections were obtained and stained with
hematoxylin-eosin. The specimens were then fixed in formalin. Paraffin blocks
of the sections were processed in the routine way and sections were stained
with hematoxylin and eosin (H and E). The diagnosis obtained by intraoperative
frozen section based on cellularity and cell morphology was compared with final
histopathological diagnosis in terms of diagnostic sensitivity, to
differentiate between benign and malignant lesions. Assessment of the overall
accuracy of the intraoperative diagnosis was classified as concordant or
discordant. Results: There was no statisticaly significant differencre in the
studied patients as regard the clinical data, macroscopic and intraoperative
picture, while there was statisticaly significat association as regard the
laterality of the ovarian masses. The validity of frozen section in the
diagnosis of benign tumour was 100% with 100% accuracy, specificity, positive
predictive value, negative predictive value, while sensitivity & negative
prediction for borderline tumour and specificity & positive prediction of
malignant tumour were 100%, specifecity for borderline tumours was 95% while
the positive predictive value was 33.3% with 96% accuracy for both malignant
and borderline tumours. Conclusion: Intraoperative frozen section is accurate
for rapid diagnosis of ovarian tumors. It can help surgeons avoid
under-treatment or overtreatment of patients. Our study was designed
prospectively using a small number of patients. The door is open to larger
studies using a larger number of patients to be performed in order to
substantiate our results.