Comparative Analysis of Histomorphological Quality and Quantitative Cell Assessment in Formalin-Fixed...

Background: Efficient tissue preservation methods are critical for accurate and quantitative microscopical examination in histopathology. Quantitative image analysis and cell counts are essential to translational research with direct implications for therapeutic decision-making. This study aims to compare the histomorphological quality of formalin-fixed paraffin-embedded (FFPE) and fresh frozen sections (FFS) in terms of tissue recognizability, physical integrity, as well as cell counts of lymphocytes, granulocytes, giant cells, and blood vessels Methods: A total of 142 skin biopsies were analyzed, with 88 FFPE and 54 with FFS. The biopsies were stained with HE and ASD. The sections were evaluated for recognizability and physical appearance, and categorized as either clearly recognizable or indistinctly recognizable, and fully intact, folded, or torn. Suited high-power fields were identified to compare the number of different cell types between the two preservation techniques. Results: FFPE showed significantly higher morphological quality than FFS in maintaining both recognizability (88.64% vs. 44.44%, p < 0.001) and physical integrity, with more sections remaining fully intact (77.27% vs. 22.22%, p < 0.001). Additionally, paraffin sections showed higher counts of lymphocytes and blood vessels (both p < 0.001) with significant statistical differences. Conclusion: The findings suggest that FFPE provides superior tissue preservation compared to FFS, particularly in maintaining structural integrity and cellular detail. This study underlines the importance of choosing appropriate embedding techniques to optimize histological evaluations, especially in clinical settings where quantitative analyses are crucial.