Role of Imprint Cytology in Diagnosis and Assessment of Surgical Margin Clearance of Tumours Compared to Frozen Section

Abstract

Introduction: Touch imprint cytology is an economical, simple and quick intraoperative diagnostic procedure with good cytological clarity but cannot provide information on the depth of invasion. Frozen section is the standard method but is limited by its cost, need of qualified technical staff and the freezing arte facts. Thus, both the techniques have their own limitations and the combination of these two methods helps in achieving high diagnostic accuracy rates. Objectives: To assess the combined role of imprint cytology and frozen section in the diagnosis of tumours and surgical margin clearance of various organs and to compare the diagnostic accuracy of imprint cytology to frozen section individually verified by subsequent histopathological examination. Material and Methods: The present study was done in the pathology department of Dhaka Medical College Hospital for a period of one year. A total of 72 surgical specimens from various organs were received for imprint cytology and frozen section. The results of both the techniques were verified by the subsequent histopathological diagnosis as “gold standard’’. Results: Out of 72 cases, majority were ovarian neoplasms comprising of 29(40.3%) cases followed by soft tissue tumours (16.7%), breast (9.7%) and brain (8.3%) neoplasms. The majority of the cases were malignant (70.83% including metastatic) followed by benign (20.83%), and borderline (8.33%). The overall diagnostic accuracy of imprint cytology and frozen section in various organs were 95.8% and 97.2% respectively. The combined diagnostic accuracy was 98.6%. The combined accuracy of surgical margin clearance in epithelial tumours was 91.66% and it was higher than the accuracy of 66.66% in non-epithelial tumours. Conclusion: The combination of imprint cytology and frozen section helps in achieving high diagnostic accuracy rates in distinguishing benign and malignant lesions and the accuracy rate for assessment of surgical margin clearance is higher in epithelial neoplasms than that in non-epithelial neoplasms in intraoperative diagnosis.