Why is there a discrepancy between intraoperative cryo-diagnosis and postoperative pathological diagnosis?

  Some patients are confused about the difference in postoperative pathological diagnosis after intraoperative frozen diagnosis, and even complain about the pathologist, we are here to analyze the analysis, and I think you will understand the pathologist’s plight after knowing the details: First of all, the accuracy of intraoperative frozen diagnosis itself is not high (90%-95%), that is, there is an objective misdiagnosis rate of 5%-10%, because: 1 is to take 1~2 pieces of material, very limited –Second, the quality of tissue sections after rapid freezing is poor, the images are not clear, and there are many diagnostic pitfalls; Third, the requirement to make a diagnosis in a very short time is a huge test for the pathologist, and it is inevitable that the busy thinking is not well thought out; Fourth, intraoperative diagnosis does not have special staining and immunohistochemistry and other auxiliary means; Fifth, freezing requires a very high level of pathologists -long experience, comprehensive knowledge, and a good grasp of the pitfalls.  Second, many tissues and diseases are not suitable for intraoperative freezing, and surgeons do not understand and send them for examination as usual: tissues that are not suitable for freezing, such as fat, bone tissue, skin tissue, calcified tissue, edema tissue, etc., cannot be frozen at all; some diseases, such as lymphatic tissue tumors, soft tissue tumors, endocrine tumors and some diseases that require counting of split phases and adequate sampling to make a diagnosis, if these diseases are done If these diseases are frozen, the clinician is setting the pathologist up to make a mistake!  Finally, it should be noted that intraoperative freezing is not a final diagnosis, but only a reference diagnosis for the surgeon, who must consider the next step in the procedure in conjunction with all other possible indicators. Currently some surgeons use freezing as a means to let the patient and the patient’s family know the pathology results earlier, which is not only against basic medical common sense, but will also lead to medical disputes!