Zulkarnain Sarah, Yunus Norhayati, Kandasamy Regunath, Zun Ahmad Badruridzwanullah, Mat Zin Anani Aila
Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kota Bharu, Kelantan, Malaysia.
Department of Pathology, Hospital Raja Perempuan Zainab II, 15586 Kota Bharu, Kelantan, Malaysia.
Asian Pac J Cancer Prev. 2020 Oct 1;21(10):3085-3091. doi: 10.31557/APJCP.2020.21.10.3085.
Glioma is the commonest primary malignant brain tumour. Diagnosis is made based on cytology smear, frozen section and histopathological examination. Intraoperative pathological diagnosis using either cytology smear, frozen section or combination of both, plays a crucial role in patient's future management and prognosis. This study aims to determine the accuracy of cytology smear and frozen section in glioma, and to compare the difference between both techniques.
A cross-sectional study was conducted involving 22 cases of glioma diagnosed intraoperatively from January 2013 until August 2019 in Hospital Universiti Sains Malaysia. The selected tissues were processed for cytology smear and frozen section. The remaining tissues were proceeded for paraffin section. The diagnosis was categorized as either low-grade or high-grade glioma based on cellularity, nuclear pleomorphism, mitotic count, microvascular proliferation and necrosis. The sensitivity and specificity of frozen section and cytology smears were determined based on paraffin section being as the gold standard. The accuracy of both techniques was compared using statistical analysis.
The overall sensitivity and specificity of cytology smear were 100% and 76.9%, respectively. Meanwhile, the sensitivity and specificity of frozen section were 100% and 84.6%. There was no significant difference in diagnostic accuracy between cytology smear and frozen section in glioma (p>0.05).
Cytology smears provides an alternative method for frozen section due to good cellularity and morphology on smear. Cytology smear is rapid, inexpensive, small amount of tissue requirement and less technical demand. This finding may benefit to the hospital or treatment centres where frozen section facility is unavailable.
胶质瘤是最常见的原发性恶性脑肿瘤。诊断基于细胞学涂片、冰冻切片和组织病理学检查。术中使用细胞学涂片、冰冻切片或两者结合进行病理诊断，对患者的后续治疗和预后起着至关重要的作用。本研究旨在确定胶质瘤细胞学涂片和冰冻切片的准确性，并比较两种技术之间的差异。
进行了一项横断面研究，纳入了2013年1月至2019年8月在马来西亚理科大学医院术中诊断为胶质瘤的22例病例。选取的组织进行细胞学涂片和冰冻切片处理。其余组织进行石蜡切片。根据细胞密度、核异型性、有丝分裂计数、微血管增生和坏死情况，将诊断分为低级别或高级别胶质瘤。以石蜡切片作为金标准，确定冰冻切片和细胞学涂片的敏感性和特异性。使用统计分析比较两种技术的准确性。
细胞学涂片的总体敏感性和特异性分别为100%和76.9%。同时，冰冻切片的敏感性和特异性分别为100%和84.6%。胶质瘤中细胞学涂片和冰冻切片的诊断准确性无显著差异（p>0.05）。
由于涂片上细胞密度和形态良好，细胞学涂片为冰冻切片提供了一种替代方法。细胞学涂片快速、廉价、所需组织量少且技术要求低。这一发现可能对没有冰冻切片设备的医院或治疗中心有益。
