Sharma Manupriya, Meyes Deychen, Bharti Sushma, Sharma Chanderdeep, Kumar Chitresh, Kumar Sudesh
Department of Pathology, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India.
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India.
J Cytol. 2025 Apr-Jun;42(2):75-81. doi: 10.4103/joc.joc_159_24. Epub 2025 May 29.
Intraoperative tumor evaluation is essential for optimizing surgical decision-making and can prevent the need for unnecessary radical surgeries. Although frozen section (FS) is the gold standard for such evaluations in advanced centers, scrape cytology presents a simpler, cost-effective alternative that could be beneficial in resource-limited settings. However, this technique is often overlooked in favor of FS due to greater pathologist confidence in FS.
This study included 80 consecutive intraoperative samples from the Department of Pathology. Both scrape cytology and FS were independently evaluated, and results were compared with those of the final histopathology, taken as the gold standard. Statistical analysis assessed the concordance, sensitivity, specificity, and diagnostic accuracy for each method.
Scrape cytology and FS demonstrated a concordance rate of 87.5%, with sensitivity and specificity of 89.3% and 90.4%, respectively, for scrape cytology. Positive predictive value was 83.3%, and negative predictive value was 94%. Scrape cytology significantly reduced diagnostic time, averaging 10 min compared to 20 min for FS. Tissue-specific discrepancies were noted, particularly in lymph nodes and parathyroid cases.
Scrape cytology proved to be a reliable, cost-effective, and time-efficient alternative to FS, especially in settings where FS is unavailable. Although FS remains optimal for architectural detail, scrape cytology provides high diagnostic accuracy and utility for intraoperative decision-making in resource-limited environments.
术中肿瘤评估对于优化手术决策至关重要，可避免不必要的根治性手术。尽管在先进中心，冰冻切片（FS）是此类评估的金标准，但刮片细胞学提供了一种更简单、成本效益更高的替代方法，在资源有限的环境中可能有益。然而，由于病理学家对FS更有信心，这种技术常常被忽视而青睐于FS。
本研究纳入了病理科连续的80份术中样本。刮片细胞学和FS均独立进行评估，并将结果与作为金标准的最终组织病理学结果进行比较。统计分析评估了每种方法的一致性、敏感性、特异性和诊断准确性。
刮片细胞学和FS的一致率为87.5%，刮片细胞学的敏感性和特异性分别为89.3%和90.4%。阳性预测值为83.3%，阴性预测值为94%。刮片细胞学显著缩短了诊断时间，平均为10分钟，而FS为20分钟。注意到了组织特异性差异，特别是在淋巴结和甲状旁腺病例中。
刮片细胞学被证明是FS的一种可靠、经济高效且省时的替代方法，尤其是在无法进行FS的情况下。尽管FS对于组织结构细节仍然是最佳选择，但刮片细胞学为资源有限环境中的术中决策提供了高诊断准确性和实用性。
