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Abstract
Introduction: The frozen section is a quick way of histopathological evaluation of tissue fragments during the intraoperative period, being an important tool to help the surgeon in decision making. Objective: To assess the diagnostic accuracy of frozen section exams in different anatomical sites performed in the pathology service of a university hospital. Material and methods: Study of an exploratory nature, with a documentary-type quantitative approach. The sample comprises 803 medical reports of the freezing and definitive paraffin exams from January 1, 2015 to January 1, 2020, available at the Pathological Anatomy Laboratory of the Professor Alberto Antunes University Hospital (HUPAA), excluding 106 reports with data that has been unavailable for whatever reason. Results: It was observed that, of the 697 surgical specimens that make up this research, 540 (77.47%) were indicated for the diagnosis of the lesion and 157 (22.53%) for the assessment of margins. The most analyzed anatomical sites were the breast in 177 cases, lymph node in 120 and skin in 106 cases. Regarding the highest number of discordant results, globally, the breast comes first with 08 cases, followed by the ovary and annexes with 05 cases and, in relation to specific sites, the peritoneum presented 10.00% of its cases, while ovary and annexes 08.47%. The anatomopathological examinations by freezing presented a rate referring to the total accuracy of 91.10%, with the breast, specifically, 94.93%, intra-abdominal 93.75% and lymph node 93.33%. Conclusion: The observed accuracy rate is high and the numbers are in line with several similar studies, which reinforces the importance of the test and the quality of the procedures performed by the service in question.
References
Vahini G, Ramakrishna BA, Kaza S, Murthy NR. Intra operative frozen section - a golden tool for diagnosis of surgical biopsies. Int Clin Pathol J. 2017 Jan; 4(1): 22-26.
Silva RDP, Souto LRM, Matsushita GM, Matsushita MM. Precisão diagnóstica das doenças cirúrgicas nos exames por congelação. Revista do Colégio Brasileiro de Cirurgiões. 2011; 38(3): 149-154. https://doi.org/10.1590/S0100-69912011000300002
Santana RP, Morais NS, Samary YRS, Bezerra ALR, Takano DM. Evaluation of the accuracy of frozen section in different anatomical sites. Jornal Brasileiro de Patologia e Medicina Laboratorial. 2018; 54(5): 319-324. https://doi.org/10.5935/1676-2444.20180053
Preeti A, Sameer G, Kulranjan S. Intra-Operative Frozen Sections: Experience at A Tertiary Care Centre. Asian Pac J Cancer. 2016 Dec; 17(12): 5057-5061.
Hatami H, Mohsenifar Z, Alavi SN. The Diagnostic Accuracy of Frozen Section Compared to Permanent Section: A Single Center Study in Iran. Iran J Pathol. 2015; 10(4): 295-299.
Abbasi F, Yekta Z, Atyan A. Accuracy of Frozen Sections. Iranian Journal of Pathology. 2012; 7(1): 3-8.
Shrestha S, Lee MC, Dhakal H, Pun CB, Pradhan M, Shrestha S, et al. Comparative study of frozen section diagnoses with histopathology. Post graduate medical journal of national academy of medical sciences. 2009; 9(2): 1-5.
Smith-Zagone MJ, Schwartz MR. Frozen section of skin specimens. Arch Pathol Lab Med. 2005; 129(12): 1536-1543.
Thomé JA, Mendiburu CF, Palma FMC, Moriel AR, Fett-Conte AC. Intraoperative frozen section assessment in the evaluation of axillary sentinel lymph node in breast cancer. J. Bras. Patol. Med. Lab., 2012 Oct; 48(5): 369-373.
Kaufman Z, Lew S, Griffel B, Dinbar A. Diagnóstico de seção congelada em patologia cirúrgica. Uma análise prospectiva de 526 seções congeladas. Câncer. 1986; 57(2): 377-379.
Instituto Nacional de Câncer José Alencar Gomes da Silva [homepage]. A situação do câncer de mama no Brasil: síntese de dados dos sistemas de informação [acesso em 20 de mar 2021]. Disponível em: https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document//a_situacao_ca_mama_brasil_2019.pdf
Instituto Nacional de Câncer José Alencar Gomes da Silva [homepage]. Estimativa 2020: incidência de câncer no Brasil [acesso em 21 de mar 2021]. Disponível em: https://www.inca.gov.br/sites/ufu.sti.inca.local/files/media/document/estimativa-2020-incidencia-de-cancer-no-brasil.pdf
Patil P, Shukla S, Bhake A, Hiwale K. Accuracy of frozen section analysis in correlation with surgical pathology diagnosis. International Journal of Research in Medical Sciences. 2017 Jan; 3(2): 399-404.
Chang JL, Tseng HH, Sheu LF, Lee WH, Tu YC. Diagnostic Accuracy of Frozen Sections in Surgical Pathology - A Retrospective Analysis of 1084 Frozen Sections. Journal of Medical Science. 1992; 13(2): 133-142.
Farah-Klibi F, Néji O, Ferjaoui M. Accuracy of frozen section diagnosis: an analysis of 1695 consecutive cases. La Tunisie Medicale. 2008 Jul; 86(7): 693-697.
Chandramouleeswari K, Yogambal M, Arunalatha P, Bose JC, Rajendran A. Frozen and paraffin sections – Comparative study highlighting the concordance and discordance rates in a tertiary care centre. Journal of Dental and Medical Sciences. India. 2013 Nov; 12(5): 26-30.
Mahe E, Ara S, Bishara M, Kurian A, Tauqir S, Ursani N, et al. Intraoperative pathology consultation: error, cause and impact. Can J Surg. 2013 Jun; 56(3): E13-E18.
White VA, Trotter MJ. Intraoperative consultation, final diagnosis correlation: relationship to tissue type and pathologic process. Arch Pathol Lab Med. 2008; 132(1): 29-36.
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Copyright (c) 2023 Dalton Bernardino Santos Silva, Camila Maria Beder Ribeiro Girish Panjwani, Juliana Arôxa Pereira Barbosa, Juliana Maria Bulhões Ferreira, Vitoria Cruz Torres, Priscilla Cordeiro Barreto, Jordanna Daynne Vieira Dos Santos, Paloma Pereira da Silva, Maria Eduarda Lopes da Silva, Denise Lauana Fernandes Oliveira