Guevara N, Lassalle S, Benaim G, Sadoul J-L, Santini J, Hofman P
Institut Universitaire de la Face et du Cou, Avenue de Valombrose, 06100 Nice, France.
Laboratoire de Pathologie Clinique et Expérimentale (LPCE), Hôpital Pasteur, Centre Hospitalo-Universitaire, Voie Romaine BP 69, 06002 Nice, France; Tumorothèque-Centre de Ressources Biologiques Hôpital Pasteur, Centre Hospitalo-Universitaire, Voie Romaine BP 69, 06002 Nice, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2015 Apr;132(2):67-70. doi: 10.1016/j.anorl.2014.02.006. Epub 2014 Dec 22.
Frozen section (FS) analysis used to be the principal examination guiding surgical strategy. The development and recent standardization of fine-needle aspiration cytology (FNAC) challenges it as a systematic attitude. The present study assessed the current contribution of FS, comparing it with FNAC as a diagnostic tool guiding surgery.
A retrospective diagnostic study analyzed 1515 thyroid samples over a 6-year period. Two hundred and fifty-two of the patients had undergone both FNAC (analyzed in our unit) and FS, revealing 69 cancers.
The sensitivity and specificity of FS and FNAC were 75.36% and 100% versus 31.88% and 100%, respectively. In case of malignancy on FNAC (22 patients), FS did not influence indications for surgery. In case of non-malignant FNAC findings, FS diagnosed cancer in 13% of cases (30/230). In the subgroup of follicular lesions (Bethesda 3 and 4), FS modified surgical strategy in only 6.2% of cases (6/97), but diagnosed 13 of the 16 cancers (81.25%) in case of Bethesda 5 on FNAC (21 cases) and in 9 of the 13 cancers (69%) associated with non-diagnostic FNAC results (Bethesda 1: 70 cases).
Although its contribution is small, FS optimizes surgery in certain cases. Systematic implementation may be economically justified, especially in follicular lesions diagnosed on FNAC, improving interpretation of a difficult and operator-dependent test, as is essential in certain FNAC results.
冰冻切片（FS）分析曾是指导手术策略的主要检查方法。细针穿刺细胞学检查（FNAC）的发展及其近期的标准化对其作为一种系统方法提出了挑战。本研究评估了FS目前的作用，并将其与作为指导手术的诊断工具的FNAC进行比较。
一项回顾性诊断研究分析了6年间的1515份甲状腺样本。其中252例患者同时接受了FNAC（在我们科室进行分析）和FS检查，共发现69例癌症。
FS和FNAC的敏感性和特异性分别为75.36%和100%，以及31.88%和100%。在FNAC显示为恶性的病例（22例患者）中，FS并未影响手术指征。在FNAC结果为非恶性的情况下，FS在13%的病例（30/230）中诊断出癌症。在滤泡性病变亚组（贝塞斯达分类3和4）中，FS仅在6.2%的病例（6/97）中改变了手术策略，但在FNAC为贝塞斯达5类的病例（21例）中诊断出了16例癌症中的13例（81.25%），以及在与无法诊断的FNAC结果（贝塞斯达1类：70例）相关的13例癌症中的9例（69%）。
尽管其作用较小，但FS在某些情况下可优化手术。系统实施在经济上可能是合理的，尤其是在FNAC诊断为滤泡性病变的情况下，有助于改善对一项困难且依赖操作者的检查的解读，这在某些FNAC结果中至关重要。
