The accuracy of frozen section in the diagnosis of ovarian tumors

Ki, Da Rin; Kim, Ki Min; Kim, Cheol Hong; Cho, Moon Kyoung; Park, So Jeong; Kim, Seok Mo; Choi, Ho Sun

Abstract

OBJECTIVE
As frozen sections play the role of determining the method or scope of operation for ovarian tumors, the present study examined the accuracy, limitations and clinical utility of frozen sections.
METHODS
Among 1583 cases of ovarian tumor surgery conducted during the period from January 1999 to September 2005, 372 for which frozen sections were sent to the Department of Pathology were analyzed through comparison between their frozen section diagnosis and final histopathological diagnosis.
RESULTS
Among the ovarian tumor cases, the accuracy of frozen section diagnosis was 91.1% and its sensitive to final diagnosis was highest as 96.0% for benign tumors, and 85.7% for malignant tumors, and as low as 62.9% for borderline?tumors (p<0.01). The positive predictive value was 87.1% for malignant tumors, 68.8% for borderline tumors, and 94.6% for benign tumors. Among the 33 cases for which frozen section did not agree with final diagnosis, 15 cases were false positive and 18 cases were false negative. Among them, 14 cases were mucinous tumors (15.4%, 14/91), showing difficulty in diagnosis compared to non-mucinous tumors (6.8%, 19/281) (p=0.018).
CONCLUSION
Despite its limitations, frozen section is a very useful method of high accuracy in diagnosing ovarian tumors. Thus, gynecologists and pathologists need to make efforts to understand the limitations and problems of frozen section, which is not highly sensitive to borderline tumors and mucinous tumors, and to make accurate diagnosis.