Guyétant S, Saint-André J P
Service d'Anatomie Pathologique, CHU, Angers, France.
Arch Anat Cytol Pathol. 1998;46(1-2):121-7.
Frozen section examination for intraoperative diagnosis is often difficult in thyroid pathology. Fine-needle aspiration is widely used in the patients selection for surgery. Such a selection is accompanied by an increase in difficult frozen section cases, whose diagnosis is often differed to permanent sections. Thus, frozen section sensitivity is relatively low. In the era of cost containment, an increasing number of authors suggest that frozen section examination is unnecessary, and that surgical planning could rely on preoperative cytology only. Others consider fine-needle aspiration cytological evaluation and frozen section examination as complementary tools and recommend their association. The authors describe the technical aspects and difficulties of frozen section examination in thyroid pathology, and discuss its interest in surgical planning, in the light of preoperative cytology. Each team has to estimate local thyroid cytology development and accuracy, to define new indications for frozen section examination in thyroid pathology, according to local therapeutic choices. Such an approach could consistently reduce the number of intraoperative consultation for thyroid pathology, without prejudice for the patients.
在甲状腺病理学中，术中诊断的冰冻切片检查往往具有难度。细针穿刺抽吸术广泛应用于手术患者的筛选。这种筛选伴随着疑难冰冻切片病例数量的增加，其诊断常常需留待永久切片。因此，冰冻切片的敏感性相对较低。在成本控制的时代，越来越多的作者认为冰冻切片检查并无必要，手术规划仅依靠术前细胞学检查即可。另一些人则将细针穿刺抽吸细胞学评估和冰冻切片检查视为互补工具，并建议二者联合使用。作者描述了甲状腺病理学中冰冻切片检查的技术要点和难点，并结合术前细胞学检查，探讨了其在手术规划中的意义。每个团队都必须评估当地甲状腺细胞学的发展情况和准确性，根据当地的治疗选择，确定甲状腺病理学中冰冻切片检查的新适应证。这种方法可以持续减少甲状腺病理学术中会诊的次数，且不会对患者造成不利影响。
