甲状腺冰冻切片是否小题大做了？

Is thyroid frozen section too much for too little?

作者信息

Richards Melanie L, Chisholm Robert, Bruder Jan M, Strodel William E

机构信息

Department of Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio 78229-3900, USA.

出版信息

Am J Surg. 2002 Dec;184(6):510-4; discussion 514. doi: 10.1016/s0002-9610(02)01074-7.

DOI:10.1016/s0002-9610(02)01074-7

PMID:12488150

Abstract

BACKGROUND

The role of frozen section (FS) in thyroid disease is controversial. The goal of this study was to identify a cohort of patients who may or may not benefit from FS.

METHODS

Two hundred thirty-one patients who underwent thyroidectomy were evaluated in regard to fine-needle aspiration (FNA), FS, and the extent of surgery.

RESULTS

In all, 155 patients underwent FNA, 140 patients underwent FS, and 103 patients had both. A final diagnosis of malignancy was obtained in 47 of 231 patients. FNA had a sensitivity of 50% and a specificity of 99%, and FS had a sensitivity of 50% and a specificity of 100% for diagnosing malignancy. Accounting for the clinical findings and FNA results, FS results altered the extent of thyroidectomy in 1 of 103 patients.

CONCLUSIONS

The increased costs for the operative time and the pathologists needed to obtain routine FS are not supported with any substantial benefit in patient outcome.

摘要

背景

冰冻切片（FS）在甲状腺疾病中的作用存在争议。本研究的目的是确定一组可能从FS中获益或未获益的患者。

方法

对231例行甲状腺切除术的患者进行细针穿刺抽吸活检（FNA）、FS及手术范围评估。

结果

总共155例患者接受了FNA，140例患者接受了FS，103例患者两者均接受。231例患者中有47例最终诊断为恶性肿瘤。FNA诊断恶性肿瘤的敏感性为50%，特异性为99%；FS诊断恶性肿瘤的敏感性为50%，特异性为100%。综合临床检查结果和FNA结果，FS结果仅使103例患者中的1例改变了甲状腺切除范围。