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KMID : 1202020080010020117
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Journal of Korean Thyroid Association
2008 Volume.1 No. 2 p.117 ~ p.122
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The Utility of Intraoperative Frozen Section Evaluation for Diagnosis of Thyroid Cancer
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Kim Hye-Young
Lee Sang-Joon
Chung Phil-Sang
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Abstract
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Background and Objectives: Fine-needle aspiration (FNA) has been established as a diagnostic technique whether patients with thyroid nodules need surgical treatment or not. However about 30% of patients with thyroid nodule receive FNA report as like "Follicular neoplasm", "Suspicious" or "Indeterminate". The aim of this study is to investigate the role of intraoperative frozen sections (FS) for increasing the diagnostic accuracy in addition to FNA.
Materials and Methods: We reviewed the medical records of 219 consecutive patients operated on for thyroid nodules from 1996 to December 2007. All patients had undergone both preoperative fine needle aspiration (FNA) and intraoperative frozen section (FS). The diagnostic findings of FNA cytology and FS histology were compared with the final pathologic results.
Results: The sensitivity, specificity and accuracy of FNA & FS were 80.8%, 83.5%, 82% and 80%, 93.4%, 86.3%, respectively. When the result of FNA was inadequate or follicular neoplasm, the surgical procedure was determined by the result of FS. The correct diagnostic rates were 78.2% and 46.1% respectively. The FS changed surgical plans approximately in 19.4% of patients, but misguided them in 7.7%. FNA and FS were found to have similar accuracy, 75.3% vs. 75.3% in papillary carcinoma and 45.5% vs. 36.4% in follicular carcinoma. In 41.6% of follicular carcinoma, malignancy may only be discovered by final histology.
Conclusion: We cannot supply proof of routinely usage of FS in the thyroid nodule. However when FNA was inadequate or atypical, intraoperative FS helps in the decision of the surgical plan.
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KEYWORD
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Fine-needle aspiration, Frozen sections, Thyroid nodule
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