[细针穿刺活检与术中冰冻组织病理评估诊断甲状腺结节的诊断准确性比较]

[Comparison between the diagnostic accuracy in diagnosis of thyroid nodules with fine needle biopsy an intraoperative histological evaluation of frozen tissue].

作者信息

Morosini P P, Mancini V, Filipponi S, Taccaliti A, Ferretti M, Gusella P, Vecchi A, Fianchini A, Fabris G

机构信息

Servizio di Citopatologia, USL 7, Ospedale Regionale, Ancona.

出版信息

Minerva Endocrinol. 1997 Mar;22(1):1-5.

PMID:9221310

Abstract

BACKGROUND

The aim of this study was to compare the diagnostic accuracy of fine needle biopsy (FNB) and intraoperative frozen-section biopsy (FS) regarding the surgical management of thyroid nodules.

METHODS

A total of 812 patients with solitary nodule or dominant nodule in a multinodular goiter were evaluated. The patients underwent preoperative FNB and intraoperative FS diagnosis.

RESULTS

The definitive histological diagnosis (HD) was: i) 222 malignant lesions (118 papillary, 67 follicular, 16 anaplastic and 8 medullary cancers); ii) 590 benign lesions. FNB accuracy was 90.6%, sensitivity 96.8% and specificity 87.1%. FS accuracy was 97.4%, sensitivity 91.3% and specificity 100%. False negative (FN) were 10 for FNB and 21 for FS. False positive (FP) were 74 for FNB and 0 for FS. FS was less sensitive for the diagnosis of papillary cancer (more FN) and more specific for the diagnosis of follicular thyroid cancers (no FP).

CONCLUSIONS

In conclusion, FS is useful in patients undergoing surgery for a thyroid nodule having a "suspicious" cytology. It adds no information in patients with an FNB diagnosis of malignancy and is of limited use in those in whom an FNB benign lesion is diagnosed.

摘要

背景

本研究旨在比较细针穿刺活检（FNB）和术中冰冻切片活检（FS）在甲状腺结节手术治疗中的诊断准确性。

方法

对812例单发结节或多结节性甲状腺肿中优势结节的患者进行评估。这些患者接受了术前FNB和术中FS诊断。

结果

最终组织学诊断（HD）为：i）222例恶性病变（118例乳头状癌、67例滤泡状癌、16例未分化癌和8例髓样癌）；ii）590例良性病变。FNB的准确性为90.6%，敏感性为96.8%，特异性为87.1%。FS的准确性为97.4%，敏感性为91.3%，特异性为100%。FNB的假阴性（FN）为10例，FS为21例。FNB的假阳性（FP）为74例，FS为0例。FS对乳头状癌的诊断敏感性较低（更多FN），对滤泡状甲状腺癌的诊断特异性较高（无FP）。