Staining collagen fibers in pituitary lesions substantially improves the certainty of intraoperative frozen section diagnosis
Authors' conclusion
This study introduces the Cason stain on frozen sections as a rapid, simple and inexpensive diagnostic tool essentially improving certainty in intraoperative histopathological diagnostics of PAs, thus facilitating surgical decision-making and optimizing clinical outcomes.
Study context
- Population
- Patients undergoing transsphenoidal surgery for pituitary lesions (pituitary adenomas (PA)/pituitary neuroendocrine tumors (PitNET)); intraoperative diagnoses compared with final diagnoses on paraffin material
- Participants
- 252 cases
- Comparison
- H&E + Cason collagen fiber stain vs H&E only on intraoperative frozen sections
- HE+Casonn = 159
- HE onlyn = 93reference
- Outcome
- Concordance of intraoperative diagnosis with final diagnosis on paraffin material (diagnostic accuracy)
Performance
As reported in the abstract
Diagnostic performance vs final paraffin diagnosis
| Test or model | Accuracy | Sensitivity | Specificity | Inconclusive cases |
|---|---|---|---|---|
| HE+Cason | 98% | 98% | 100% | 0% |
| HE only | 87% | 90% | 40% | 11% |
Accuracy
HE+Cason98%
HE only87%
Sensitivity
HE+Cason98%
HE only90%
Specificity
HE+Cason100%
HE only40%
Inconclusive cases
HE+Cason0%
HE only11%
- HE+Cason vs HE only: P < 0.001
- HE+Cason vs HE only: P < 0.05
- HE+Cason vs HE only: P = 0.06
- HE+Cason vs HE only: P < 0.001
Original publication
Staining collagen fibers in pituitary lesions substantially improves the certainty of intraoperative frozen section diagnosis. Pituitary. Published 25 September 2026. doi:10.
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