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甲状腺手术中术前细针穿刺细胞学检查与冰冻切片检查的比较

Preoperative fine-needle aspiration cytology versus frozen section in thyroid surgery.

作者信息

Ersoy E, Taneri F, Tekin E, Poyraz A, Cihan A, Dursun A, Onuk E

机构信息

Department of General Surgery, Gazi University Medical Faculty, Besevler, Ankara, Turkey.

出版信息

Endocr Regul. 1999 Sep;33(3):141-4.

Abstract

OBJECTIVE

In a double blind prospective clinical study to evaluate the diagnostic potential of peroperative fine needle aspiration cytology as compared to peroperative frozen section in thyroid surgery.

METHODS

The diagnostic value of one hundred consecutive preoperative (FNA) and peroperative fine needle aspiration (p-FNA), frozen section (FS) and permanent section (PS) examination for thyroid nodules were studied prospectively in order to assess and compare the accuracy, sensitivity and specificity.

RESULTS

Out of 100 patients PS showed 11 % of malignancies, while p-FNA showed 5 % and FS showed 6% of malignant cases with no false positive, but with 6 and 5 false negative results, respectively. Thus, as compared with FS, one false negative finding was obtained by p-FNA in a case of malignant tumor which could be definitely ascertained by frozen section technique. However, concerning the benign nodules no differences were found between p-FNA and FS.

CONCLUSIONS

Peroperative fine needle aspiration seems to be a useful method which can be properly performed because the nodule can be easily seen during the surgical procedure. However, further clinical observations of large numbers of patients are needed.

摘要

目的

在一项双盲前瞻性临床研究中,评估甲状腺手术中术中细针穿刺细胞学检查与术中冰冻切片检查相比的诊断潜力。

方法

前瞻性研究连续100例甲状腺结节术前细针穿刺(FNA)、术中细针穿刺(p-FNA)、冰冻切片(FS)及永久切片(PS)检查的诊断价值,以评估和比较其准确性、敏感性及特异性。

结果

100例患者中,PS显示11%为恶性肿瘤,p-FNA显示5%,FS显示6%为恶性病例,均无假阳性,但分别有6例和5例假阴性结果。因此,与FS相比,p-FNA在1例经冰冻切片技术可明确诊断为恶性肿瘤的病例中出现了1例假阴性结果。然而,对于良性结节,p-FNA与FS之间未发现差异。

结论

术中细针穿刺似乎是一种有用的方法,由于在手术过程中结节易于观察,该方法能够恰当实施。然而,仍需要对大量患者进行进一步的临床观察。

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