The Diagnostic Accuracy of Frozen Section Compared to Permanent Section: A Single Center Study in Nepal Mediciti Hospital

Frozen section plays a major role in the surgical management of patients with neoplastic and non-neoplastic disease. Since its introduction in the late 20th century, the use of frozen section has spectacularly increased. It provides the surgeon with important pathologic information while the patient is on the operating table. There are many indications for performing frozen section, including determination of the nature and extent of a lesion, evaluation of surgical margins and assessment of adequacy of tissue for diagnosis. This study evaluated the diagnostic accuracy of frozen sections over a 2-year period in a Department of Laboratory medicine and Pathology, Nepal Mediciti Hospital, Sainbu, Lalitpur, Nepal. It retrospectively reviewed frozen sections performed in the Pathology Department of Nepal Mediciti Hospital, Lalitpur, Nepal for 2 years. The results were compared to the permanent sections to evaluate diagnostic accuracy, sensitivity and specificity, of frozen section test. Discordant cases were reassessed to find the reasons for discrepancy. It evaluated a total of N=100 frozen section specimens. In two specimens (2%) the diagnoses were deferred, of the remaining 98 specimens, four specimen (4.0%) were discordant and 94 specimen (94%) were concordant to permanent diagnoses. The overall sensitivity, specificity, positive predictive value and negative predictive value of the frozen section compared to permanent section (as gold standard) were 100 %, 96.6 %, 100 % and 96.6 % respectively. Among the 4 discordant diagnoses, two (2%) were due to sampling error and two (2 %) were due to interpretative errors. Adequate and accurate sampling is recommended and also interpretation error should be minimized to help reducing the rate of discordant cases. The results of this study also confirm that the accuracy of frozen section diagnosis in our institution compares well with internationally published data.