Validitv of Frozen Section in Cervical Conization

Surintip Piamsomboon, Wipa Paholpak, Thamasin Virathpongsanon, Dittakarn Boriboonhirunsarn, Thitiwan Kongprasit, Chairat Leelapatanadit', Suthi Sangarat, Sumrit Sanapad, Pichai Charoenpanich
Obj€ctive: To €valuat€ th€ validity of pathological diagnosis of cervicsl cone specimetrs prepared by froz€n s€ction comparcd with paraffir s€ction. Study derign : Diagnostic test evaluation Setting : Pathology division, Depsrtment of Obstetrica and Gvnecologv, Facdty of Medicin€ Siriraj Hospital, Mahidol University. M€thods : C€rvical con€ specim€ns from 78 patisnts who underwent cold knife conization at Siriraj Hospital from Octob€r 1997 to Sept€mber 1998 were proccssed bv frozen section
more » ... ique and the pathological disgnoses were made immediat€ly. Th€ remaining cone tiss e from each specimen was processed to produce permanent paraffin s€ctionB for a linal diagnosis. The frozen and permanent pathologicsl diagnos€s were compar€d. R$ult : Th€ pathological diagnosis from fmz€n sectron was in complet€ agreement with the perman€nt sectioln h &.24qa of patients. When lhe subj€cts were divided into thr€e groups; normal and CINI, CINI-m and MIC and invasive cancer, the Kappa analFis for agr€ement of the pathological diagnoses b€twe€n the two m€thods was 0.46 (fair agreement). For th€ diagnosis of invasiv€ cancer by frozen section, the se$itivity, spe€ilicitv, positive and negative predictiv€ value, false negative and false pGifive 'Nere 62.5,97' 71.4' 95.A' 31.5 and Lgq.' rcspectiv€ly. Ther€ werc thr€e case of invasive cancer on permanent paralfrn secrion which wer€ diagnosed by frozen section as MIC in iwo csses and CINII in th€ other. Conclusion : Frozen s€ction evaluation of a c€rvical cone sp€cimen crrrics onlv a modemte degree of agr€em€nt with permanent paraffin section. For the diagnosis of invasiv€ cancer in thiB study, froz€n section has a low sensitivity and s high false n€gative rst€, The diagnosis oI micminvasive cancer was srbject to signiffcant er.or. The diagnosis of microinvasive cancer by froz€n section needs additional careful r€view of the p€rmanent section. aPatholog! dit,ision, Department oJ obstettics and G1n:colagv' Fac ltf of Medicine Sirimj Hospitat, Mah ial Unh)rtsity,