Intraoperative rapid and accurate pathological diagnosis of lung nodules is crucial for formulating individualized surgical strategies. Frozen section remains the most widely used intraoperative diagnostic method. However, its diagnostic performance may be compromised by structural alterations of lung tissue and difficulties in distinguishing early-stage lung adenocarcinoma subtypes. Modified frozen section techniques and rapid immunohistochemistry have improved diagnostic accuracy to some extent through optimized specimen preparation and the incorporation of molecular marker detection. In recent years, emerging diagnostic technologies based on physical and chemical signals, including mass spectrometry, spectroscopy, and bioelectrical impedance spectroscopy, have developed rapidly. By analyzing the molecular composition, optical characteristics, or dielectric properties of tissues, these techniques enable rapid identification of lung nodules and have shown promising potential for tumor discrimination and histological classification. This article reviews the current advances in intraoperative rapid diagnostic techniques for lung nodules.
