Histological examination of peroperative frozen sections in suspected lung cancer.

Nashef, Samer A.M.; Kakadellis, John; Hasleton, Philip; Whittaker, J. S.; Gregory, Christopher; Jones, Mark T.

doi:10.1136/thx.48.4.388

Cited by 15 publications

(7 citation statements)

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“…A total of 28 articles were selected as potentially relevant. [3][4][5][6][7][8][9][10][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] However, only 5 of these studies had sufficient level III and IV evidence about the results of pathologic evaluation of solitary pulmonary nodules in patients with a history of breast cancer. 7-10,16 Levels of evidence have been categorized by Sackett et al 35,36 and range from strongest (I) to weakest (V).…”

Section: Methodsmentioning

confidence: 99%

Evidence-Based Criteria to Help Distinguish Metastatic Breast Cancer From Primary Lung Adenocarcinoma on Thoracic Frozen Section

Herbst¹,

Jenders

McKenna

et al. 2009

American Journal of Clinical Pathology

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The distinction between primary lung adenocarcinoma and metastatic breast carcinoma in patients with a history of breast cancer is difficult by frozen section (FS) analysis. Our experience with 129 FSs from 121 patients with a pulmonary nodule and a history of breast cancer was reviewed. The pretest odds ratio of primary pulmonary carcinoma/metastatic breast carcinoma was 2.6. The incidence of 12 histopathologic features was assessed in a "training set" composed of 20 FSs, 10 with primary lung adenocarcinoma and 10 with metastatic breast cancer. A differential diagnosis model composed of significant pathologic features that favor the diagnosis of primary lung adenocarcinoma (acini, lepidic growth, nuclear pseudoinclusions, and scar) or metastatic breast carcinoma (comedonecrosis, solid nests, trabecular architecture, and cribriform growth) was identified. The external validity of this model was successfully tested by challenging 19 pathologists and trainees with a test set of 20 unknown FSs, supporting the clinical applicability of the diagnostic model.

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Section: Methodsmentioning

confidence: 99%

Evidence-Based Criteria to Help Distinguish Metastatic Breast Cancer From Primary Lung Adenocarcinoma on Thoracic Frozen Section

Herbst¹,

Jenders

McKenna

et al. 2009

American Journal of Clinical Pathology

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“…Whilst histology is recommended for all patients prior to completion of definitive surgery, in cases of very high a priori of malignant lesions, some surgeons may opt to perform surgical resection without histology. Our model is based on a 75% rate of frozen section in patients undergoing lung resection without pre-operative histologythis is in line with other series examining the rate of frozen section in patients referred for surgery without histology 12,13 , and in line with our own local experience, but the lack of national-level data regarding surgical practice is a limitation.…”

Section: Discussionmentioning

confidence: 75%

Pre-surgical lung biopsy in management of solitary pulmonary nodules: a cost effectiveness analysis

Barnett

Belsey²,

Tavare

et al. 2019

Journal of Medical Economics

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Objectives: Tissue diagnosis prior to thoracic surgery with curative intent is vital in thoracic lesions concerning for lung cancer. Methods of obtaining tissue diagnosis are variable within the United Kingdom. Methods: We performed a model-based analysis to identify the most efficient method of diagnosis using both a health care perspective. Our analysis concerns adults in the UK presenting with a solitary pulmonary nodule suspicious for a primary lung malignancy, patients with more advanced disease (for example lymph node spread) were not considered. Model assumptions were derived from published sources and expert reviews, cost data were obtained from healthcare research group cost estimates (2016-17). Outcomes were measured in terms of costs experienced to healthcare trusts. Results: Our results show that CT guided percutaneous lung biopsy using an ambulatory approach, is the most cost-effective method of diagnosis. Indeed, using this approach, trust experience approximately half of the cost of an approach of surgical lung biopsy performed at the time of potential resection ('frozen section'). Limitations and conclusions: Whilst this analysis is limited to the specific scenario of a solitary pulmonary nodule, these findings have implications for the implementation of lung cancer screening in the UK, which is likely to result in increased numbers of patients with such early disease.

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“…The measurements lasted for 2-5 minutes and the contact measurement did not affect or destroy the samples. The LNs were then diagnosed with FS to determine whether further excisions were necessary (18,19).…”

Section: Measurementsmentioning

confidence: 99%

Dielectric property measurements for the rapid differentiation of thoracic lymph nodes using XGBoost in patients with non-small cell lung cancer: a self-control clinical trial

Lu¹,

Peng²,

Wang³

et al. 2022

Transl Lung Cancer Res

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Background: One of the important criteria for thoracic surgeons in making surgical strategies is whether the thoracic lymph nodes (LNs) are metastatic. Frozen section (FS) is widely used as an intraoperative diagnostic method, which is time-consuming and expensive. The dielectric property, including permittivity and conductivity, varies with different tissues. The extreme gradient boosting (XGBoost) is a powerful classifier and widely used. Thus, this study aims to develop the rapid differentiation method combining dielectric property and XGBoost, and assess its efficacy on the thoracic LNs in patients with non-small cell lung cancer (NSCLC).Methods: This was a single center self-control clinical trial with paraffin pathology section (PPS) results as gold diagnosis. The LNs from the pathologically diagnosed patients with NSCLC were recruited, whichwere measured by open-ended coaxial probe for the dielectric property within 1-4,000 MHz after removal from the patients and then were sent to perform FS and PPS diagnosis. The XGBoost combining with dielectric property was developed to differentiate malignant LNs from benign LNs. The classified efficacy was determined using the receiver operator characteristic (ROC) curve and area under the curve (AUC).Results: A total of 204 LNs from 67 NSCLC patients were analyzed. The mean values of the two parameters differed significantly (P<0.001) between benign and malignant LNs. The AUC for permittivity and conductivity were 0.850 [95% confidence interval (CI): 0.786 to 0.915; P<0.001] and 0.887 (95% CI: 0.828 to 0.946; P<0.001), respectively. The AUC was 0.893 (95% CI: 0.834 to 0.951; P<0.001) when the two parameters were combined. After the application of the XGBoost, the AUC was 0.968 (95% CI: 0.918 to 1.000; P<0.001), and the accuracy was 87.80%. Its sensitivity was 58.33% and the specificity was 100%.When the Synthetic Minority Oversampling Technique (SMOTE) algorithm was used, the AUC was 0.954 (95% CI: 0.883 to 1.000; P<0.001) and the accuracy was 92.68%. Its sensitivity was 83.33% and the specificity was 96.55%.Conclusions: This method might be useful for thoracic surgeons during surgery, for its relatively high efficacy in rapid differentiation of LNs for patients with NSCLC.

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Histological examination of peroperative frozen sections in suspected lung cancer.

Cited by 15 publications

References 0 publications

Evidence-Based Criteria to Help Distinguish Metastatic Breast Cancer From Primary Lung Adenocarcinoma on Thoracic Frozen Section

Evidence-Based Criteria to Help Distinguish Metastatic Breast Cancer From Primary Lung Adenocarcinoma on Thoracic Frozen Section

Pre-surgical lung biopsy in management of solitary pulmonary nodules: a cost effectiveness analysis

Dielectric property measurements for the rapid differentiation of thoracic lymph nodes using XGBoost in patients with non-small cell lung cancer: a self-control clinical trial

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