2012, Number 3
<< Back Next >>
Rev Cub Med Mil 2012; 41 (3)
Frozen section biopsy in surgical disorders of the thyroid gland
Navas IJ, González TR, Ramos GIY, Hernández TI, Martínez AMV
Language: Spanish
References: 12
Page: 229-236
PDF size: 53.90 Kb.
ABSTRACT
Introduction: thyroid nodules continue to pose a challenge to surgeons. The risk of not detecting a malignant neoplasia persists, even when an intraoperative frozen section biopsy is performed. Several authors are of the opinion that this test yields a large number of inconclusive results. Thyroid echography and fine-needle cytology, in combination with an appropriate clinical evaluation, have become the main pillars of a more rational management of thyroid nodules.
Objective: compare the results of intraoperative frozen section biopsy with echography-guided fine-needle cytology with paraffin biopsy (PB).
Methods: across-sectional study was conducted of 331 patients operated on for thyroid gland disorders. True positive, false positive, true negative, false negative and suspicious or doubtful results, were all taken into account in the analysis. The Galen and Gambino test was applied to these results to obtain the sensitivity, specificity, predictive values and efficiency of both procedures.
Results: 58 % of the series corresponded to benign disorders and 42 % to malignant disorders. Echography-guided fine-needle cytology showed specificity (99.1 %), sensitivity (99.2 %), negative predictive value (99.2 %), efficiency (97.1 %), and full sensitivity (99.2 %).
Conclusions: echography-guided fine-needle cytology is a reliable procedure to establish the preoperative diagnosis of thyroid nodules.
REFERENCES
Bomeli SR, LeBeau SO, Ferris RL. Evaluation of a thyroid nodule Otolaryngol Clin North Am. 2010 April;43(2):229-38.
Frates MC, Benson CB, Doubilet PM, Kunreuther E, Contreras M, Cibas ES, et al. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab. 2006;91(9):3411-7.
Sidawy MK, Del Vecchio DM, Knoll SM. Fine-needle aspiration of thyroid nodules: correlation between cytology and histology and evaluation of discrepant cases. Cancer. 1997;81(4):253-9.
Singer PA. Evaluation and management of the solitary thyroid nodule. Otolaryngol Clin North Am. 1996;29(4):577-91.
Sidawy MK, Del Vecchio DM, Knoll SM. Fine-needle aspiration of thyroid nodules: correlation between cytology and histology and evaluation of discrepant cases. Cancer. 1997;81(4):253-9.
Barroeta JE, Wang H, Shiina N, Gupta PK, Livolsi VA, Baloch ZW. Is fine-needle aspiration (FNA) of multiple thyroid nodules justified? Endocr Pathol. 2006;17(1):61-5.
Frates MC, Benson CB, Doubilet PM, Kunreuther E, Contreras M, Cibas ES, et al. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab. 2006;91(9):3411-7.
McCoy KL, Jabbour N, Ogilvie JB, Ohori NP, Carty SE, Yim JH. The incidence of cancer and rate of false-negative cytology in thyroid nodules greater than or equal to 4 cm in size. Surgery. 2007;142(6):837-44.
Raza SN, Shah MD, Palme CE, Hall FT, Eski S, Freeman JL. Risk factors for well-differentiated thyroid carcinoma in patients with thyroid nodular disease. Otolaryngol Head Neck Surg. 2008;139(1):21-6.
Nam-Goong IS, Kim HY, Gong G, Lee HK, Hong SJ, Kim WB, et al. Clin. Ultrasonography-guided fine-needle aspiration of thyroid incidentaloma: correlation with pathological findings. Endocrinol (Oxf). 2004 Jan;60(1):21-8.
Cheng MS, Morgan JL, Serpell JW. Does frozen section have a role in the intraoperative management of thyroid nodules? ANZ J Surg. 2002;72(8):570-2.
LiVolsi VA, Baloch ZW. Use and abuse of frozen section in the diagnosis of follicular thyroid lesions Thyroid. 2005 Jul;15(7):708-17.