Comparative Diagnostic Utility of Squash, Scrape and Imprint cytology in Intraoperative Diagnosis of Ovarian Tumours.

Abstract

Introduction: Intraoperative cytology in ovarian tumors involves collecting cell samples from the ovarian sample sent during surgery and quickly examining them for diagnostic information. Frozen section provides rapid diagnosis to guide intraoperative patient management. The indications of frozen section are identification of tissue, evaluation of margins and identification of lymph nodes metastasis.

Aim: To evaluate comparative diagnostic utility of squash smear, scrape smear and imprint cytology with frozen section in intraoperative ovarian tumour.

Materials and methods: Intraoperative tissue from clinico-radiologically suspected ovarian. tumour for frozen section taken and processed in Department of Pathology and Laboratory Medicine. Squash smear, scrape smear and imprint smear were made. Three stains (Rapid MGG, Rapid Pap and Rapid H & E) with expected TAT of <15 minutes were done. Intraoperative cytological smear (squash, scrape and imprint smear) were correlated with frozen section & Histopathology slide. Final assessment of intraoperative cytological smears for diagnostic accuracy was done using statistical study.

Results: Sensitivity, Specificity, and Diagnostic accuracy for frozen and cytology were: Sensitivity of frozen section, squash cytology and scrape cytology was 91.67% in all three, whereas sensitivity of imprint was 87.5%. Specificity of frozen section, imprint cytology, squash cytology and scrape cytology was 96.77%, 93.55%, 90.32% and 90.32% respectively and accuracy was 94.55%, 90.91%, 90.91% and 90.91% respectively.

Conclusion: Imprint, squash, and scrape cytology has similar sensitivity and specificity compared to frozen section in identifying the nature of lesion and can be an alternative to frozen section in resource stricken setting.