The value of frozen sectioning for the evaluation of resection margins in cases of conization.

OBJECTIVES

To determine the role of frozen section examination (FSE) of the cone specimen in the evaluation of the resection margin status and to rule out invasion in patients with high-grade cervical intraepithelial neoplasia.

METHODS

Thirty patients with cervical intraepithelial neoplasia underwent conization followed by FSE and planned hysterectomy. The results of the definitive paraffin exam were compared with FSE.

RESULTS

In evaluation of the margins by FSE, 4 patients (13%) had positive cone margines and 26 (87%) had negative margins. The definitive of paraffin examination of margin status was concordant in all the cases. Intraoperative diagnosis of invasion was made in three cases such that all of them were invasive squamous cell carcinoma. Among the remaining 27 cases, we detected five CIN1, two CIN2 and three CIN3, so the diagnosis of the FSE was concordant with paraffin section in 26 out of 30 cases (87%). Also we detected four additional CIN (one CIN 1, two CIN2 and one CIN3) after paraffin study, whose frozen specimens were reported normal.

CONCLUSION

Frozen section examination can provide immediate and precise evaluation of the cone margin status in high-grade cervical intraepithelial neoplasia. It can identify frank invasion and permit adequate treatment in a one-stage procedure and reliably detect clear resection margins.