Kahmke Russel, Lee Walter T, Puscas Liana, Scher Richard L, Shealy Michael J, Burch Warner M, Esclamado Ramon M
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Duke University Medical Center, Duke University, Durham, NC 27710, USA.
Int J Otolaryngol. 2013;2013:496138. doi: 10.1155/2013/496138. Epub 2013 Jan 21.
Objective. To describe the usefulness of intraoperative frozen section in the diagnosis and treatment of thyroid nodules where fine needle aspirate biopsies have evidence of follicular neoplasm. Study Design. Retrospective case series. Methods. All patients have a fine needle aspirate biopsy, an intraoperative frozen section, and final pathology performed on a thyroid nodule after initiation of the Bethesda System for Reporting Thyroid Cytopathology in 2009 at a single tertiary referral center. Sensitivity, specificity, positive predictive value, and negative predictive value are calculated in order to determine added benefit of frozen section to original fine needle aspirate data. Results. The sensitivity and specificity of the frozen section were 76.9% and 67.9%, respectively, while for the fine needle aspirate were 53.8% and 74.1%, respectively. The positive and negative predictive values for the fine needle aspirates were 25% and 90.9%, respectively, while for the frozen sections were 27.8% and 94.8%, respectively. There were no changes in the operative course as a consequence of the frozen sections. Conclusion. Our data does not support the clinical usefulness of intraoperative frozen section when the fine needle aspirate yields a Bethesda Criteria diagnosis of follicular neoplasm, suspicious for follicular neoplasm, or suspicious for malignancy at our institution.
目的。描述术中冰冻切片在诊断和治疗甲状腺结节中的作用，这些甲状腺结节的细针穿刺活检有滤泡性肿瘤的证据。研究设计。回顾性病例系列。方法。自2009年在单一的三级转诊中心启动甲状腺细胞病理学报告的贝塞斯达系统后，所有患者均对甲状腺结节进行了细针穿刺活检、术中冰冻切片及最终病理检查。计算敏感性、特异性、阳性预测值和阴性预测值，以确定冰冻切片相对于原始细针穿刺数据的附加益处。结果。冰冻切片的敏感性和特异性分别为76.9%和67.9%，而细针穿刺活检的敏感性和特异性分别为53.8%和74.1%。细针穿刺活检的阳性和阴性预测值分别为25%和90.9%，而冰冻切片的阳性和阴性预测值分别为27.8%和94.8%。冰冻切片未导致手术过程发生改变。结论。在我们机构，当细针穿刺活检依据贝塞斯达标准诊断为滤泡性肿瘤、可疑滤泡性肿瘤或可疑恶性肿瘤时，我们的数据不支持术中冰冻切片的临床实用性。
