The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Prognostic Value of Frozen Section and Touch Imprint Cytology for Intra-operative Differentiation of Benign and Malignant Ovarian Tumors

Document Type : Original Article

Authors
Sara Rasta 1
Malihe Hasanzadeh Mofrad 2
Ali Emadi-Torghabeh 3
Nourieh Sharifi 4
1 Resident, Department of Radiotherapy and Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Associate professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Assistant professor, Department of Radiotherapy and Oncology, Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Professor, Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
10.22038/ijogi.2020.17075
Abstract
Introduction: Frozen section (FS) is a valuable method with high sensitivity and specificity which allows the surgeon to choose a suitable therapeutic plan in a short time. High cost and inaccessibility are the most important limitations of this method in many pathology laboratories. Touch imprint (TI) is a rapid and inexpensive method in this field. This study was performed with aim to compare the frozen section and touch imprint methods for intra-operative differentiation of benign and malignant ovarian tissues.
Methods: In this cross-sectional study which was performed in 2012, 45 ovarian tissue samples which had been sent to the pathology department of Mashhad Ghaem hospital were evaluated by three methods of frozen section, touch imprint and permanent paraffin. Data analysis was performed using SPSS statistical software (version 16) and cross tab test. P less than 0.05 was considered significant.
Results: Accuracy of FS and TI were 97.8% and 84.4%, respectively. Sensitivity and specificity was 95.7% and 100% for FS and was 69.6% and 100% for TI. Moreover, Positive and negative predictive value was 100% and 96.6% for FS and was 72.7%% and 75.9% for TI.
Conclusion: FS is a sensitive and specific method for evaluation of malignancy tissues. TI alone cannot be replaced by this method, but if FS was not accessible, IT could be used as a rapid method for intraoperative evaluation of tissue samples.
Keywords
Cytology
Frozen section
Intra-operative diagnosis
Touch imprint
  1. Schmoll H-J, Van't Meer L, Vermorken J, Schrijvers D. ESMO Handbook of cancer diagnosis and treatment evaluation: CRC Press; 2009.
  2. Rosai J. Rosai and Ackerman's surgical pathology e-book: Elsevier Health Sciences; 2011.
  3. Medeiros LR, Rosa DD, Edelweiss MI, Stein AT, Bozzetti MC, Zelmanowicz A, et al. Accuracy of frozen-section analysis in the diagnosis of ovarian tumors: a systematic quantitative review. Int J Gynecol Cancer 2005; 15(2):192-202.
  4. Ranchod M. Intraoperative consultation in surgical pathology: Cambridge University Press; 2010.
  5. Acs G, Baloch ZW, LiVolsi VA, editors. Intraoperative consultation: an historical perspective. Seminars in diagnostic pathology; 2002.
  6. Motomura K, Inaji H, Komoike Y, Kasugai T, Nagumo S, Noguchi S, et al. Intraoperative sentinel lymph node examination by imprint cytology and frozen sectioning during breast surgery. Br J Surg 2000; 87(5):597-601.
  7. Turner RR, Giuliano AE. Intraoperative pathologic examination of the sentinel lymph node. Ann Surg Oncol 1998; 5(8):670-672.
  8. Mair S, Lash RH, Suskin D, Mendelsohn G. Intraoperative surgical specimen evaluation: frozen section analysis, cytologic examination, or both? A comparative study of 206 cases. Am J Clin Pathol 1991; 96(1):8-14.
  9. Oneson RH, Minke JA, Silverberg SG. Intraoperative pathologic consultation. An audit of 1,000 recent consecutive cases. Am J Surg Pathol 1989; 13(3):237-243.
  10. Czerniak B, Rosai J. Role of cytology in intraoperative diagnosis. A practical guide. Pathol Annu 1995; 30 Pt 2:83-102.
  11. Azami S, Aoki Y, Iino M, Sakaguchi A, Ogura K, Ogishima D, et al. Useful aspects of diagnosis of imprint cytology in intraoperative consultation of ovarian tumors: comparison between imprint cytology and frozen sections. Diagn Cytopathol 2018; 46(1):28-34.
  12. Bohara S, Jain S, Khurana N, Shangpliang DM, Agarwal S, Gandhi G. Intraoperative Cytology of Ovarian Neoplasms with an Attempt to Grade Epithelial Tumors. J Cytol 2018; 35(1):1-7.
  13. Dey S, Misra V, Singh PA, Mishra S, Sharma N. Role of intraoperative imprint cytology in diagnosis of suspected ovarian neoplasms. Asian Pac J Cancer Prev 2010; 11(5):1389-1391.
  14. Allameh Z, Rohahamin S, Mohamadzadeh F, Allameh T. Accuracy of Frozen Section in Diagnosis of Ovarian Mass in Isfahan Medical Hospital 2005. Iran J Obstet Gynecol Infertil 2007; 9(2):7-10.
  15. Rose PG, Rubin RB, Nelson BE, Hunter RE, Reale FR. Accuracy of frozen-section (intraoperative consultation) diagnosis of ovarian tumors. Am J Obstet Gynecol 1994; 171(3):823-826.
  16. Twaalfhoven FC, Peters AA, Trimbos JB, Hermans J, Fleuren GJ. The accuracy of frozen section diagnosis of ovarian tumors. Gynecol Oncol 1991; 41(3):189-192.
  17. Pinto PB, Andrade LG, Derchain S. Accuracy of intraoperative frozen section diagnosis of ovarian tumors. Gynecologic oncology 2001; 81(2):230-2.
  18. Obiakor I, Maiman M, Mittal K, Awobuluyi M, DiMaio T, Demopoulos R. The accuracy of frozen section in the diagnosis of ovarian neoplasms. Gynecologic oncology 1991; 43(1):61-3.
  19. Ilvan S, Ramazanoglu R, Akyildiz EU, Calay Z, Bese T, Oruc N. The accuracy of frozen section (intraoperative consultation) in the diagnosis of ovarian masses. Gynecologic oncology 2005; 97(2):395-9.
  20. Chang M, Chen R, Ho W. Intraoperative cytology: the use of Liu's stain for immediate diagnosis. Zhonghua yi xue za zhi= Chinese medical journal; Free China ed 1993; 51(5):368-75.
  21. Scucchi LF, Di Stefano D, Cosentino L, Vecchione A. Value of cytology as an adjunctive intraoperative diagnostic method. An audit of 2,250 consecutive cases. Acta Cytol 1997; 41(5):1489-1496.
  22. Melies M, Agamia A, Abdallah D, Rady H, Selim A. Evaluation of Intraoperative Imprint Cytology in Ovarian Tumors. J Cytol Histol 2018; 9(523):2.
  23. Memar B, Sadeghi R, Ayati NK, Aledavood SA, Tghizadeh A, Naseri S, et al. The value of touch imprint cytology and frozen section for intra-operative evaluation of axillary sentinel lymph nodes. Pol J Pathol 2010; 61(3):161-5.

The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 23, Issue 7
September 2020
Pages 22-28