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

Document Type: Research Articles

Authors

1 Department of Pathology, King George's Medical University, Lucknow

2 Department of Surgical Oncology King George's Medical University Lucknow

3 Department of Endocrine Surgery, King George's Medical University, Lucknow

4 Department of Surgery, King George's Medical University, Lucknow

5 Department of Pathology, King George's Medical University, Lucknow

6 Senior Resident, Department of Pathology, KGMU, Lucknow 226003, UP, India

7 Professor, Department of Pathology, KGMU, Lucknow 226003, UP, India

Abstract

 
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 seven cases incorrect interpretations were made. Epithelial dysplasia was observed on definitive histology in two cases which was not reported intra-operatively. One case was of ectopic thyroid. In cases of oral cancer where sentinel lymph nodes were sampled, immunohistochemistry for cytokeratin was performed to facilitate identification of micrometastasis. Only single case displayed tumor deposits which was not evident morphologically. Resection margins were reported 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 was 97.5%. Careful observation, pathologist experience and knowledge of limitations help in improving the overall diagnostic outcome.

Keywords