Diagnostic accuracy of tru-cut biopsy and acid cytology from patients operated with suspicious for ovarian cancer

TL;DR

The study compares the accuracy of tru-cut biopsy and acid cytology in diagnosing ovarian cancer, finding both methods highly reliable and accurate.

Contribution

The study demonstrates that combining tru-cut biopsy and acid cytology can replace more invasive diagnostic procedures for ovarian cancer.

Findings

Acid cytology had 64% sensitivity and 65% accuracy, while tru-cut biopsy had 91% sensitivity and 92% accuracy.

Combined use of both methods achieved 93% sensitivity and 93% accuracy with no false positives.

The combined methods are reliable enough to potentially replace invasive diagnostic procedures like laparoscopy.

Abstract

In women who are believed to have ovarian cancer but have a poor performance status or have advanced disease thought to be beyond the scope of primary cytoreductive surgery, neoadjuvant chemotherapy can be administered with acid cytology and/or tru-cut biopsy referral. The aim of this study was to determine the accuracy, adequacy, safety, and reliability of these minimally invasive interventional procedures.

This is a retrospective analysis of 63 patients with a suspicion of ovarian cancer who reported to Bezmialem University Hospital between 2014 and 2021, underwent ultrasound-guided acid cytology and tru-cut biopsy, and also had postoperative final pathology results.

On comparing acid cytology and tru-cut biopsy at the same time with the postoperative final pathology results, it was seen that the positive predictive value was 100% in all groups. It was revealed that the sensitivity of acid cytology was 64%, the specificity was 100%, the negative predictive value was 12%, and the accuracy of the test was 65%. The sensitivity of the tru-cut biopsy was 91%, the specificity was 100%, the negative predictive value was 42%, and the accuracy of the test was 92%. In the case of both procedures, the sensitivity was calculated as 93% and the accuracy of the test was calculated as 93%. There were no false-positive cytology and biopsy results.

Due to its high reliability and accuracy, the combined application of these minimally invasive methods has the potential to routinely replace more invasive methods for adequate tumor sampling, such as diagnostic laparoscopy or exploratory laparotomy.

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