Frozen Section Diagnosis: An Emphasis on Reasons, Accuracy and Errors for Discordance

Abstract

The purpose of the investigation was comparing rates of intra-operative frozen section diagnosis with final diagnosis on paraffin section in order to assess concordant, discordant, and postponed diagnosis rates and to identify the causes of discordance. The connection of intra-operative frozen section diagnosis with permanent section final diagnosis is a crucial aspect of surgical pathology quality assurance. A retrospective analysis of 117 cases of frozen section biopsy was carried out which were reported in the Histopathology department between July 2007 to June 2012.  The correlation between the frozen section diagnosis with final histological diagnosis was performed in order to check the accuracy of the technique.  The number and type of discrepancies were compared, causes for the discrepancies were analysed in order to decrease the avoidable errors and improve on the frozen section diagnoses. The overall accuracy of frozen section diagnoses over 5years was 90.60% with false positive rate of 0.85%, false negative rate of 6.84% and 1.71% of deferred diagnosis. Sensitivity was 87.69% and Specificity was 98%. The discrepancies were mainly due to the interpretation error, sampling error and technical artefacts. Gross inspection, pathologist sample, frozen sections combined with cytological and histological analysis, and collaboration among consultants can help to escape some restrictions and give the quick, trustworthy, and affordable information needed for the best possible patient treatment.