Touch Imprint Cytology: Can It Serve as an Alternative to Frozen Section in Intraoperative Assessment of Cervical Metastasis in Oral Squamous Cell Carcinoma?

PURPOSE

The purpose was to assess the diagnostic accuracy of touch imprint cytology (TIC) compared with frozen section (FS) analysis as an intraoperative diagnostic tool to assess nodal metastasis in oral squamous cell carcinoma.

MATERIALS AND METHODS

We intraoperatively assessed 38 patients undergoing neck dissection for oral squamous cell carcinoma, wherein a total of 248 nodes were sectioned and subjected to TIC and, subsequently, FS analysis and were finally submitted to the gold-standard histopathologic examination. The sensitivities, specificities, positive predictive values (PPVs), and negative predictive values (NPVs) of TIC and FS analysis for the detection of metastasis in the cervical nodes were determined with the corresponding 95% confidence intervals.

RESULTS

TIC had a sensitivity of 62.86%, specificity of 96.24%, PPV of 73.33%, NPV of 94.04%, and accuracy of 91.53% compared with histopathologic results. The sensitivity of FS analysis was 60%, specificity was 98.12%, PPV was 84%, NPV was 93.72%, and accuracy was 92.74% compared with histopathologic examination. These results of TIC were comparable to those of FS analysis.

CONCLUSIONS

TIC is a straightforward, quick, and reliable technique. It has a definitive role in being used as an adjunct to FS analysis to increase intraoperative diagnostic accuracy. It can serve as a useful technique in centers that do not have FS availability.