Diagnostic accuracy of intraoperative touch imprint cytology and frozen sections for the evaluation of margin status and diagnosis of oro-pharyngeal squamous cell carcinomas

Abstract

<p>Background and Objective: In surgical procedures, accurate intraoperative diagnosis is essential for guiding surgical management. Two common techniques employed for rapid intraoperative diagnosis are touch imprint cytology (TIC) and frozen section (FS). However, their diagnostic accuracy as compared to histopathology remains under debate. This study therefore aims to evaluate the diagnostic precision of FSs and TIC taking histopathology as a gold standard in oropharyngeal squamous cell carcinoma (OPSCC) biopsies.</p> <p>Methods: A total of 122 biopsies of OPSCC were received for FS analysis at the Histopathology Department of the University College of Medicine and Dentistry Lahore, Pakistan. Touch imprints were taken from the surgical margins of the same biopsies and FSs were cut and stained with rapid Hematoxylin and Eosin stain following standard protocols. Paraffin-embedded histopathology sections were later made from the same tissues for comparison and diagnostic accuracy studies.</p> <p>Results: Comparison of FS with histopathology showed a sensitivity of 60%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 95%, and overall diagnostic accuracy of 95%. On comparison of TIC with histopathology, sensitivity was 86.6%, specificity was 100%, PPV was 100%, NPV was 98.2%, and accuracy was 98.3%.</p> <p>Conclusion: In comparison to histopathology, TIC and FS examination have promising utility as well as certain limitations for the evaluation of the margin status of OPSCC specimens. Thus, with careful consideration, these techniques may provide valuable insights for clinical practice in local settings with both time and cost-effective approaches.</p>