Diagnostic Utility Of Intraoperative Scrape Cytology Of Ovarian Mass Lesions: A Study Of 89 Cases From A Tertiary Care Centre

Abstract

Background: Intraoperative evaluation of ovarian mass lesions plays a crucial role in guiding surgical decisions. Scrape cytology smears (SS) have gained popularity for intraoperative consultation due to their rapid turnaround time, simplicity, and excellent preservation of cytomorphological details, especially in settings where frozen section (FS) facilities are limited.

Aim: This study aims to assess the diagnostic utility of scrape cytology in the intraoperative assessment of ovarian masses and to compare its accuracy with frozen sections, using histopathology as the reference standard.

Materials and Methods: A prospective study was carried out over four years (2019–2024) at a tertiary care center involving freshly received ovarian mass specimens. Intraoperative scrape cytology smears and frozen sections were prepared and interpreted independently. Scrape smears were categorized cytologically into four groups: Indeterminate (low cellularity), Benign, Borderline (equivocal morphology), and Malignant. Diagnostic performance was evaluated against the final histopathological diagnosis.

Results: Scrape cytology demonstrated a sensitivity of 80.95%, specificity of 97.8%, positive predictive value of 97.1%, and negative predictive value of 85.1%. The overall diagnostic accuracy for identifying malignant lesions was 89.88%. Tumor subclassification was feasible in 66 of 89 cases (74%).

Conclusion: Scrape cytology is a reliable, rapid, and cost-effective technique for intraoperative diagnosis of ovarian tumors, particularly beneficial in resource-limited settings. With adequate training in sampling and interpretation, scrape cytology can serve as an effective adjunct or alternative to frozen sections for intraoperative evaluation of ovarian masses.