Role of frozen section analysis in nodular thyroid pathology - 28/03/15
, S. Lassalle b, c, 1, G. Benaim b, J.-L. Sadoul d, J. Santini a, P. Hofman b, cBienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Introduction |
Frozen section (FS) analysis used to be the principal examination guiding surgical strategy. The development and recent standardization of fine-needle aspiration cytology (FNAC) challenges it as a systematic attitude. The present study assessed the current contribution of FS, comparing it with FNAC as a diagnostic tool guiding surgery.
Material and methods |
A retrospective diagnostic study analyzed 1515 thyroid samples over a 6-year period. Two hundred and fifty-two of the patients had undergone both FNAC (analyzed in our unit) and FS, revealing 69 cancers.
Results |
The sensitivity and specificity of FS and FNAC were 75.36% and 100% versus 31.88% and 100%, respectively. In case of malignancy on FNAC (22 patients), FS did not influence indications for surgery. In case of non-malignant FNAC findings, FS diagnosed cancer in 13% of cases (30/230). In the subgroup of follicular lesions (Bethesda 3 and 4), FS modified surgical strategy in only 6.2% of cases (6/97), but diagnosed 13 of the 16 cancers (81.25%) in case of Bethesda 5 on FNAC (21 cases) and in 9 of the 13 cancers (69%) associated with non-diagnostic FNAC results (Bethesda 1: 70 cases).
Conclusion |
Although its contribution is small, FS optimizes surgery in certain cases. Systematic implementation may be economically justified, especially in follicular lesions diagnosed on FNAC, improving interpretation of a difficult and operator-dependent test, as is essential in certain FNAC results.
Le texte complet de cet article est disponible en PDF.Keywords : Thyroid, Frozen section, Fine-needle aspiration cytology, Surgery, Biobank resource center, Molecular biology
Plan
Vol 132 - N° 2
P. 67-70 - avril 2015 Retour au numéro
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