Evaluation of Intraoperative Imprint Cytology in Ovarian Tumors

Imprint cytology has been widely used in intraoperative diagnosis of various tumors. But its use in intraoperative diagnosis of ovarian neoplasms has not been widely recognized. There are only a few reports describing its accuracy and validity. We undertook this study to evaluate the accuracy of imprint cytology in the diagnosis of ovarian neoplasms and correlate it with histopathological diagnosis, taking it to be the gold standard. The present study was on 100 patients undergoing surgery for ovarian masses. For every ovarian mass imprint cytology was done and then compared to the final histopathologic diagnosis. Imprint cytology in benign cases showed that 81.8% patients were negative and 18.2% patients were positive while in border line all cases were positive and in malignant group 11.9% patients were negative and 88.1% patients were positive. There was statistically significant difference between the studied groups where P<0.001. Imprint cytology was associated with the highest diagnostic accuracy (84.88% ) with sensitivity of 88.10% and specificity of 81.82% with a positive predictive value of 82.22% and a negative predictive value of 87.80%. Imprint cytology is a less expensive, simple, fast and reliable method for diagnosis of various ovarian neoplasms. The limitations we experienced in the study was insufficient cellularity in a few cases and interpretation errors especially in case of borderline epithelial tumors. Diagnostic accuracy can be improved by extensive sampling in case of large ovarian tumors. Careful architectural assessment should be done. It is also recommended to correlate with clinical and radiological findings for better results. Imprint cytology does not alter the quality of biopsy specimen. Materials obtained from imprint can be used for flow cytometry and cytogenetic studies.