Yadav Gajendra Kumar, Phulware Ravi H, Singh Ashok, Kumar Arvind, Durgapal Prashant, Chowdhury Nilotpal, Rao Shalinee, Rajaram Shalini, Kishore Sanjeev, Mundhara Rajlaxmi
Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Dehradun, India.
Acta Cytol. 2025;69(4):399-407. doi: 10.1159/000545110. Epub 2025 Mar 24.
Intraoperative cytology in ovarian tumours involves collecting cell samples from the ovarian sample sent during surgery and quickly examining them for diagnostic information. Frozen section provides rapid diagnosis to guide intraoperative patient management. The indications of frozen section are identification of tissue, evaluation of margins, and identification of lymph nodes metastasis.
Intraoperative tissue from clinico-radiologically suspected ovarian tumour for frozen section taken and processed in Department of Pathology and Laboratory Medicine. Squash smear, scrape smear, and imprint smear were made. Three stains rapid May-Grünwald Giemsa, rapid papanicolaou (Pap), and rapid hematoxylin and eosin with expected turnaround time of <15 min were done. Intraoperative cytological smear (squash, scrape, and imprint smear) were correlated with frozen section and histopathology slide. Final assessment of intraoperative cytological smears for diagnostic accuracy was done using statistical study. The aim of this study was to evaluate comparative diagnostic utility of squash smear, scrape smear, and imprint cytology with frozen section in intraoperative ovarian tumour is the aim of study.
Sensitivity, specificity, and diagnostic accuracy for frozen and cytology were: sensitivity of frozen section, squash cytology, and scrape cytology was 91.67% in all three, whereas sensitivity of imprint was 87.5%. Specificity of frozen section, imprint cytology, squash cytology, and scrape cytology was 96.77%, 93.55%, 90.32%, and 90.32%, respectively, and accuracy was 94.55%, 90.91%, 90.91%, and 90.91%, respectively.
Imprint, squash, and scrape cytology have similar sensitivity and specificity compared to frozen section in identifying the nature of lesion and can be an alternative to frozen section in resource stricken setting.
卵巢肿瘤术中细胞学检查是指从手术送检的卵巢样本中采集细胞样本，并迅速对其进行检查以获取诊断信息。冰冻切片可提供快速诊断，以指导术中患者管理。冰冻切片的适应证包括组织识别、切缘评估和淋巴结转移的识别。
对临床放射学怀疑为卵巢肿瘤的术中组织进行取材，并在病理与检验医学科进行冰冻切片处理。制作压片涂片、刮片涂片和印片涂片。采用快速迈-格二氏染色、快速巴氏染色和快速苏木精-伊红染色，预期周转时间<15分钟。将术中细胞学涂片（压片、刮片和印片涂片）与冰冻切片及组织病理学切片进行对比。通过统计学研究对术中细胞学涂片的诊断准确性进行最终评估。本研究的目的是评估压片涂片、刮片涂片和印片细胞学检查与冰冻切片在术中卵巢肿瘤诊断中的比较诊断效用。
冰冻切片和细胞学检查的敏感性、特异性和诊断准确性如下：冰冻切片、压片细胞学检查和刮片细胞学检查的敏感性在三者中均为91.67%；而印片的敏感性为87.5%。冰冻切片、印片细胞学检查、压片细胞学检查和刮片细胞学检查的特异性分别为96.77%、93.55%、90.32%和90.32%，准确性分别为94.55%、90.91%、90.91%和9 : 91%。
在识别病变性质方面，印片、压片和刮片细胞学检查与冰冻切片具有相似的敏感性和特异性，在资源匮乏的情况下可作为冰冻切片的替代方法。
