甲状腺结节冰冻切片检查的诊断价值——设拉子医院的手术情况（1997 - 2000年）

Diagnostic value of frozen section examination in thyroid nodule--surgery at the Shariati Hospital (1997-2000).

作者信息

Shirzad Mahmood, Larijani Bagher, Hedayat Anushiravan, Kamalian Nassar, Baradar-Jalili Reza, Bandarian Fatemeh, Tavangar Seyed Mohammad, Akrami Seyed Mohammad

机构信息

Endocrinology and Metabolism Research Centre, Tehran University of Medical Sciences (TUMS).

出版信息

Endocr Pathol. 2003 Fall;14(3):263-8. doi: 10.1007/s12022-003-0019-x.

DOI:10.1007/s12022-003-0019-x

PMID:14586072

Abstract

INTRODUCTION

There is controversy regarding the use and accuracy of frozen section (FS) in managing thyroid nodules. We compared the diagnostic value of FS with that of permanent histopathology examination and fine needle aspiration (FNA).

MATERIALS AND METHODS

Permanent, FS, and FNA sample reports were compared in 214 patients between 1997 and 2000. FS, FNA, and permanent pathology (gold standard) results were compared using McNemar's test.

RESULTS

160 women and 54 men (mean age: 42.3 +/- 5.4 yr) took part in the study; 163 patients (76%) had benign and 51 (24%) malignant lesions; 76% of our thyroid cancer cases were papillary, 13.5% follicular, 6% medullary carcinoma, 4% Hürthle cell carcinoma, and 0.5% anaplastic carcinoma. FNA yielded definite results in 150 patients (sensitivity 72%, specificity 96%, and precision 90%). In 64 patients with equivocal FNA, FS was performed (sensitivity 36%, specificity 73%, and precision 85%). The observed difference between FNA and FS was not statistically significant.

DISCUSSION

When FNA results are inconclusive, FS does not provide any further information. In suspected cases of papillary, undifferentiated, or medullary carcinomas, FS can confirm FNA findings and guide surgical therapy.

摘要

引言

在甲状腺结节的处理中，关于冰冻切片（FS）的应用及准确性存在争议。我们比较了FS与永久组织病理学检查及细针穿刺抽吸活检（FNA）的诊断价值。

材料与方法

对1997年至2000年间214例患者的永久切片、FS及FNA样本报告进行比较。使用McNemar检验比较FS、FNA及永久病理学（金标准）结果。

结果

160名女性和54名男性（平均年龄：42.3±5.4岁）参与了本研究；163例患者（76%）有良性病变，51例（24%）有恶性病变；我们的甲状腺癌病例中，76%为乳头状癌，13.5%为滤泡状癌，6%为髓样癌，4%为许特莱细胞癌，0.5%为未分化癌。FNA在150例患者中得出明确结果（敏感性72%，特异性96%，精确性90%）。在64例FNA结果不明确的患者中进行了FS（敏感性36%，特异性73%，精确性85%）。FNA与FS之间观察到的差异无统计学意义。