[Accuracy of frozen section diagnosis: an analysis of 1695 consecutive cases].
BACKGROUND
The intraoperative frozen section is a well established procedure for rapid diagnosis that helps in making therapeutic decisions.


OBJECTIVE
Assessment of the accuracy of frozen section diagnosis and analysis of the causes of its discordance.


METHODS
A retrospective review of 1695 surgical specimens performed in 1207 patients between January 2002 and April 2005. Frozen section results were compared with the final diagnoses in paraffin sections.


RESULTS
The frozen section diagnosis was benign in 84.2%, malignant in 10.2% and borderline in 0.4% of all cases. The frozen section result was deffered to permanent section in 5.2%. The sensitivity, specificity, positive and negative predictive values were 84.6%, 99.8%, 98.2% and 97.8% respectively. Overall diagnostic agreement was 97.5% (Kappa=0.88). Frozen section diagnosis was incorrect in 2.5% of cases. Most of the discrepancies were false negative cases frequently due to sampling errors and misinterpretation. False positive cases were always related with misinterpretation.


CONCLUSIONS
The frozen section evaluation is highly accurate and reliable. However, the surgeon and the pathologist must be aware of its limitations.
Farah-Klibi
Faten
F
Laboratoire d'Anatomie et de Cytologie Pathologiques, Hôpital Charles Nicolle, Tunis.
Néji
Olfa
O
Ferjaoui
Mohamed
M
Zaouche
Abdeljalil
A
Koubâa
Abdelhamid
A
Sfar
Rachida
R
Najeh
Nabil
N
Ben Jilani
Sarrah
S
Zermani
Rachida
R
D005260:Female; D005629:Frozen Sections; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D009369:Neoplasms / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity