Duek Simon D, Goldenberg David, Linn Shai, Krausz Michael M, Hershko Dan D
Department of Surgery, Rambam Medical Center and B. Rappoport Faculty of Medicine, Technion-Israel Institute of Technology, Bat Galim, Haifa.
Surg Today. 2002;32(10):857-61. doi: 10.1007/s005950200167.
We evaluated the role of intraoperative frozen section (FS) in the surgical management of solitary thyroid nodules, as its true value is a subject of some controversy.
We reviewed the records of 206 consecutive patients operated on for solitary thyroid nodules. All patients had undergone both preoperative fine-needle aspiration (FNA) and intraoperative FS. The diagnostic findings of FNA cytology and FS histology were compared with the final histological results.
There were 61 patients with cancer and 145 with various benign conditions. The sensitivity and specificity of FNA were 78.1% and 96.5%, respectively, demonstrating an overall accuracy of 91.3%. The sensitivity, specificity, and accuracy rates for FS were 83.3%, 95.2%, and 91.7%, respectively. FS altered the operative decision in 14 patients, but correctly so in only 8 patients. Correlated with FNA cytology, the yield of FS in assisting in the intraoperative decision making was 1.8%, 3.4%, and 5.2% for benign, malignant, and suspicious cytology, respectively.
When the results of FNA and FS are interpreted as either benign or malignant, both are highly accurate predictors of the pathological nature of the nodule. However, the findings of the present study do not support the use of FS in the surgical management of solitary thyroid nodules, regardless of FNA cytology.
我们评估了术中冰冻切片（FS）在孤立性甲状腺结节手术管理中的作用，因为其真正价值存在一定争议。
我们回顾了206例连续接受孤立性甲状腺结节手术患者的记录。所有患者均接受了术前细针穿刺抽吸（FNA）和术中FS。将FNA细胞学和FS组织学的诊断结果与最终组织学结果进行比较。
有61例癌症患者和145例患有各种良性疾病的患者。FNA的敏感性和特异性分别为78.1%和96.5%，总体准确率为91.3%。FS的敏感性、特异性和准确率分别为83.3%、95.2%和91.7%。FS改变了14例患者的手术决策，但只有8例决策正确。与FNA细胞学相关，FS在协助术中决策方面，良性、恶性和可疑细胞学的检出率分别为1.8%、3.4%和5.2%。
当FNA和FS的结果被解释为良性或恶性时，两者都是结节病理性质的高度准确预测指标。然而，本研究结果不支持在孤立性甲状腺结节的手术管理中使用FS，无论FNA细胞学结果如何。
