Frozen Section Diagnostic Accuracy in Intraoperative Surgical Histopathology of Rajavithi Hospital

Abstract

Background: An intraoperative diagnosis is a preliminary diagnosis that guide the management of the patient during the surgery. These may lead to a discrepancy between intraoperative diagnosis and subsequent permanent section. An accuracy validation will help to improve understandings between surgeon and pathologists, and also increase the treatment efficiency. Objective: To assess the accuracy, precision and specificity of intraoperative diagnosis, identifying the causes of misdiagnosis and analyzing for solution. Method: This was a retrospective study comparing between intraoperative diagnosis and subsequent permanent section in Rajavithi Hospital between January 1, 2018 and December 31, 2019. Results: There were 727 included cases. There was a concordance rate of 92.98% (676/727 patients) between the intraoperative diagnosis and permanent section diagnosis. The sensitivity rate was 81.86% while the specificity rate was 98.00%. Positive predictive value was 94.87% while negative predictive value was 92.29%. The accuracy rate was 92.98%. The period prevalence of cancer and/or positive margin was 31.09%. Conclusion: The frozen section accuracy in Rajavithi Hospital is in line with other institute in the literature. Surgeon should be aware of sources of false positive and negative that can occur.