Diagnostic accuracy of frozen section: experience at Fatima Jinnah Medical University, Lahore

Abstract

Background: The surgical approach and management depends on frozen section examination results and is
variable for different frozen section results. Frozen section examination is a quick and reliable preliminary
diagnostic intraoperative technique that allows surgeons to take immediate correct decisions at the operating
table. In this study, the diagnostic accuracy of frozen section examination was determined at Fatima Jinnah
Medical University, Lahore.
Patients and methods: Frozen section database from 1
st January 2016 to 31st December 2017 was
retrospectively reviewed and compared with permanent sections to determine the diagnostic accuracy,
sensitivity and specificity of frozen section technique. The study included 103 cases. The cases were divided
into concordant and discordant cases. The diagnostic disagreements were analyzed to determine the cause of
discrepancy.
Results: Total 103 frozen section specimens were evaluated. The anatomical site was primarily the ovary,
axillary lymph node, breast, skin, thyroid, uterus and kidney. Among them 102 (99.03%) cases were concordant
and 1 (0.97%) case was discordant. The discordant case was false negative and the specific site was the ovary.
There was no false positive result. The overall sensitivity, specificity, diagnostic accuracy, positive predictive
value and negative predictive value of frozen section examination compared to permanent section were 97.6%,
100%, 99%, 100% and 98.4% respectively. For individual anatomic locations, the diagnostic accuracy ranged
from 97.9% to 100%. The diagnostic discrepancy was due to sampling error.
Conclusion: Frozen section is a highly accurate, valuable and reliable technique for making rapid preliminary
intraoperative diagnosis, thus enabling surgeons in taking correct immediate decisions regarding appropriate
surgical approach and further management at the operating table