Role of frozen sections in the evaluation of moderate to severe dysplasia during uterine cervix conization.

BACKGROUND

The utility of frozen section examination (FSE) of cone specimens in evaluation of the resection margin status and in ruling out invasion in patients with high grade cervical intraepithelial neoplasia requires evaluation.

METHODS

Twenty patients with high grade cervical intraepithelial neoplasia who underwent conization biopsy and frozen section examination were studied in a prospective trial from March 2008 through September 2009. The results with permanent paraffin sections were compared with those of FSE.

RESULTS

Among the twenty cases, 15 (75%) had the same results in frozen and permanent sections of cone biopsy specimens. Among the other 5 patients, 2 had high grade cervical intraepithelial neoplasia in frozen sections and 2 showed a lower grade while only one case was found in which the FSE result was CIN3 while the permanent section showed invasive carcinoma which was of clinical importance and considered as significant. Paired sample t-testing showed no significant difference in the results of the two groups of frozen and permanent sections (P=0.716, CI=95%).

CONCLUSION

Frozen section evaluation of cervical cone biopsy specimens in patients with a diagnosis of CIN 3 is accurate, efficient and cost-effective. Because of the great importance of missing even one case, further research is highly recommended on this controversial subject.