Hamburger J I, Hamburger S W
Surgery. 1985 Aug;98(2):307-12.
Needle biopsy (Bx) is superior to clinical selection of thyroid nodules for surgery. Is it superior to frozen section (FS) for surgical planning? Comparison of accuracy of the two procedures was made for 359 patients who underwent both procedures. Bx diagnoses consistent with a low risk of cancer predict a benign lesion at surgery with 90% accuracy. FS on the same patients was also 90% reliable in identifying benign or malignant nodules. Bx diagnoses consistent with a high risk of cancer predict a malignant lesion at surgery with 91% accuracy. FS on the same patients identified only 70% of the cancers. However, false positive diagnoses of cancer were less by FS. Bx diagnoses on nodules with an intermediate risk of cancer (32% to 43%) were insufficiently sensitive for reliable surgical planning. FS on the same nodules was also unreliable. Only three of 359 FS diagnoses contributed decisively to surgical planning. Reliance on Bx could eliminate as many as 99% of FSs.
针吸活检（Bx）在选择甲状腺结节进行手术方面优于临床诊断。在手术规划中，它是否优于冰冻切片（FS）呢？对359例同时接受这两种检查的患者进行了这两种检查准确性的比较。与低癌症风险一致的Bx诊断预测手术时良性病变的准确率为90%。对同一批患者进行的FS在识别良性或恶性结节方面的可靠性也为90%。与高癌症风险一致的Bx诊断预测手术时恶性病变的准确率为91%。对同一批患者进行的FS仅能识别70%的癌症。然而，FS对癌症的假阳性诊断较少。Bx对癌症风险为中等（32%至43%）的结节的诊断在可靠的手术规划方面敏感性不足。对同一结节进行的FS也不可靠。在359例FS诊断中，只有3例对手术规划有决定性作用。依靠Bx可以消除多达99%的FS检查。
