Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Integration of Biomarkers, Sonographical Findings, Frozen Section with Histopathological Analysis in Ovarian Neoplasms: A Tertiary Care Center Perspective
Divya Nagaram, Devasmita Gain, Kavya Nagesh and N. Thamarai Selvi
Page: 353-358 | Received 20 Aug 2024, Published online: 28 Oct 2024
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Abstract
Ovarian cancer, the third most common malignancy among women in India, presents with high mortality rates due to late diagnosis. Intraoperative frozen section analysis plays a pivotal role in surgical management by providing a rapid histopathological diagnosis. This study evaluates the accuracy of frozen section diagnosis in comparison to final histopathological diagnoses and its role in guiding surgical decisions for ovarian lesions. Aim of the study was to assess the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of frozen section diagnosis for ovarian tumors. Additionally, the study aims to correlate frozen section findings with preoperative biomarkers and imaging results. This retrospective study was conducted at the Department of Pathology, Vydehi Institute of Medical Sciences and Research Center, Bangalore, over 18 months (January 2023 to June 2024). A total of 57 cases of ovarian lesions underwent frozen section analysis. Relevant clinical, biomarker and radiological data were collected. Frozen sections were compared to final diagnoses made from formalin‐fixed paraffin‐embedded (FFPE) sections. Diagnostic accuracy measures, including sensitivity, specificity, PPV and NPV, were calculated. The study found that frozen section diagnosis had a sensitivity of 94%, specificity of 96%, PPV of 95% and NPV of 97%. A concordance rate of 96.5% was observed between frozen section diagnoses and final histopathological diagnoses. The most common ovarian lesions diagnosed were serous borderline tumors (14.04%) and mucinous cystadenomas (12.28%). Two cases were discordant, including one of lymph angiomatous vascular proliferation and another of a follicular cyst. Biomarker analysis showed wide variation in CA‐125 levels, with a mean value of 140.05U/ml, but this was not always correlated with malignancy. Frozen section diagnosis is a highly reliable tool for the intraoperative assessment of ovarian lesions, with high sensitivity and specificity. While it plays a crucial role in surgical management, especially for real‐time decision‐making, diagnostic limitations exist, particularly for complex lesions like mucinous and borderline tumors. Further research with larger sample sizes is recommended to refine diagnostic accuracy in these challenging cases.
How to cite this article:
Divya Nagaram, Devasmita Gain, Kavya Nagesh and N. Thamarai Selvi. Integration of Biomarkers, Sonographical Findings, Frozen Section with Histopathological Analysis in Ovarian Neoplasms: A Tertiary Care Center Perspective.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.11.353.358
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.11.353.358