Abstract of Study (Max 300 Words): Introduction: Frozen section (FS) is an intraoperative technique which provides valuable information for the management of patients. It is used for determining the nature of lesion, evaluation of margin status of malignant tumor resections, nodal metastasis, tissue identification and aliquoting tissue for further special studies. Regular analysis of frozen and permanent section (PS) diagnosis in an institute acts as a quality control and helps in identification of causes of discordance between them and subsequent improvement in diagnostic accuracy of FS.
Objective: To study the concordance rate (CR) of intraoperative FS diagnosis with gold standard PS diagnosis.
Materials and Methods: This descriptive cross sectional study was carried out in the department of Histopathology, Northwest General Hospital and Research Center from June 2021 to November 2022. All the consecutive FS cases along with their permanent tissue samples were included. Diagnoses of frozen sections were made by two pathologists. The concordance and deferral rates were calculated and causes of discordance were analysed.
Results: Of the total 147 FS received, 75 (51%) were from Neurosurgery, 60 (40.8%) from hepatobiliary surgery, and 12 (8.2%) from ENT. Age range was 4-82 years ± 16.8 SD and 83 cases (56.5%) were from male patients. Seven cases (4.76%) were deferred to PS. Among the remaining 140 cases, 42 were from tumor margins which showed 100% CR, while the remaining 98 cases were for diagnosis of pathological process, which showed 96.94% CR. The overall CR was 97.85%. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 95.3%, 99.0%, 97.6% and 98.1% respectively.
Conclusion: Strong concordance between IFS and final pathology results showed that IFS is reliable. Adequate sampling both by surgeon and pathologist and preparation of good quality slides may further improve the diagnostic accuracy of FS.
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