Department of Ultrasound, the Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, 310009, China.
Department of Pathology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, 310009, China.
Sci Rep. 2017 Jul 12;7(1):5244. doi: 10.1038/s41598-017-05459-x.
Intraoperative frozen section (FS) can be reduced during thyroid lobectomy according to the results of fine needle aspiration (FNA). We evaluated the role of intraoperative FS in thyroid nodules with different diagnostic categories of the Bethesda System for Reporting Thyroid Cytopathology by FNA. This retrospective study included 1,235 nodules collected via thyroidectomy with both preoperative FNA and intraoperative FS at the Second Affiliated Hospital of Zhejiang University School of Medicine, from January 2011 to January 2014. FNA cytological diagnosis was classified into six categories, based on the Bethesda system. The diagnostic findings of FNA cytology and FS histology were compared with the final histological results. 189 nodules were benign. The remainder were malignant. FS diagnosis was more accurate than FNA diagnosis for nodules classified as Bethesda Categories II, III, and IV (P < 0.05). However, the accuracy of FNA diagnosis in nodules assigned Bethesda Categories V and VI was significantly higher than that of FS (P < 0.05). FS appears be beneficial for thyroid nodules classified as Bethesda categories I through IV. FS may not be necessary in nodules diagnosed as Bethesda Categories V and VI.
术中冰冻切片（FS）可根据细针穿刺抽吸（FNA）的结果在甲状腺叶切除术中减少。我们评估了术中 FS 在通过 FNA 进行甲状腺细针抽吸细胞学诊断的 Bethesda 系统报告甲状腺细胞学中的不同诊断类别的甲状腺结节中的作用。这项回顾性研究包括 2011 年 1 月至 2014 年 1 月期间在浙江大学医学院第二附属医院通过甲状腺切除术收集的 1235 个结节，这些结节均进行了术前 FNA 和术中 FS。根据 Bethesda 系统，将 FNA 细胞学诊断分为六个类别。比较 FNA 细胞学和 FS 组织学的诊断结果与最终组织学结果。189 个结节为良性。其余为恶性。对于被归类为 Bethesda 类别 II、III 和 IV 的结节，FS 诊断比 FNA 诊断更准确（P<0.05）。然而，在被归类为 Bethesda 类别 V 和 VI 的结节中，FNA 诊断的准确性明显高于 FS（P<0.05）。FS 似乎对被归类为 Bethesda 类别 I 至 IV 的甲状腺结节有益。在被诊断为 Bethesda 类别 V 和 VI 的结节中，FS 可能不是必需的。
