Diagnostic Accuracy of Cytology Smear and Frozen Section in Glioma

Document Type: Systematic Review and Meta-analysis


Department of Pathology, School of Medical Science, Health Campus, University Sains Malaysia, Kelantan, Malaysia.


Glioma is the commonest primary intracranial tumour and it has been the most predominant tumour in many studies.
It accounts for 24.7% of all primary brain tumour and 74.6% of malignant brain tumour. Intraoperative diagnosis
plays a crucial role in determining the patient management. Frozen section has been the established technique in
providing rapid and accurate intraoperative diagnosis. However due to some disadvantages like ice crystal artefact,
high expenditure and requirement of skilled technician, there is increase usage of cytology smear either replacing or
supplementing frozen section technique. The aim of this review is to determine the diagnostic accuracy of cytology
smear and frozen section in glioma and to see whether there is significant difference between those techniques. The
overall diagnostic accuracy for frozen section in glioma ranging from 78.4% to 95% while for cytology smear, the
diagnostic accuracy ranging from 50% to 100%. Based on certain literatures, no statistically difference was observed
in diagnostic accuracy of cytology smear and frozen section. Thus, cytology smear provides an alternative method in
establishing intraoperative diagnosis. Both cytology smear and frozen section are complimentary to each other. It is
recommended to use both techniques to improve the diagnostic accuracy in addition with adequate knowledge, clinical
history, neuroimaging and intraoperative findings.


Main Subjects