Diagnostic Accuracy of Frozen Section in Salivary Gland Neoplasms

Abstract

Introduction: Research over the years has systematically revealed that
morphological, histological, and molecular data from human cancers
available to pathologists has revolutionized quantitative systems science. By
measuring morphological parameters such as tumor stage and grade, it is
now possible to integrate relatively large data sets thus reconceptualization
of knowledge available, provides better prediction of the behavior of tumors
and their interaction with the host. Histological diagnosis prior to surgery is
not possible, as incisional biopsies are contraindicated due to the possibility
of facial nerve injury and incomplete resection of the tumor. Objective: To
compare the results of the frozen section examination with definitive
histological diagnosis. Identifying malignancy intraoperatively can have a
significant impact on the management of the salivary gland tumors.
Materials and Methods: The study was done in Histopathology department
of SIMS/Services hospital, Lahore. 40 cases of salivary gland neoplasms
previously diagnosed on FNAC. Results: Comparing the perioperative
result with definitive diagnosis, 10% (6/40) were true positive, 77.5% (31/40)
true negative, 7.5% (3/40) false positive, 0% (0/40) false negative,
prevalence, 66.6% positive predictive value and 100% negative predictive
value. Thus, the sensitivity of frozen section for malignancy was 100% and
the specificity was 91%. Conclusion: We consider that frozen section
examination for salivary gland neoplasms is not sufficient on its own for
deciding on the best management. Their interpretation must be correlated
with clinical and intraoperative findings, in association with surgeon's
experience.