Frozen section analysis in the post-Bethesda era
| Autor: | Jing Xin, John Sandyhya, Mark S. Cohen, Travis M. Cotton, Paul G. Gauger, Barbara S. Miller, David T. Hughes, Roy Lirov |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Thyroid nodules medicine.medical_specialty Study groups Biopsy Fine-Needle 030209 endocrinology & metabolism Thyroid Lobectomy Sensitivity and Specificity Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Adenocarcinoma Follicular medicine Frozen Sections Humans Thyroid Neoplasms Thyroid cancer Aged Retrospective Studies Frozen section procedure business.industry Carcinoma Cancer Middle Aged medicine.disease Bethesda system for reporting thyroid cytopathology Carcinoma Papillary Surgery Thyroid Cancer Papillary 030220 oncology & carcinogenesis Thyroidectomy Female Radiology business |
| Zdroj: | Journal of Surgical Research. 205:393-397 |
| ISSN: | 0022-4804 |
| Popis: | Background The utility of frozen section (FS) for indeterminate thyroid nodules is controversial. In 2009, the Bethesda System for Reporting Thyroid Cytopathology was established to further subcategorize indeterminate fine-needle aspiration results (follicular lesions, FL) into Bethesda category 3 (BC3) and Bethesda category 4 (BC4). We hypothesize that FS will have less utility in the evaluation of BC3 lesions when compared to BC4. Materials and methods A total of 479 patients who underwent thyroid lobectomy from January 2008 to July 2014 were retrospectively reviewed. Patients without appropriate Bethesda categorization were excluded. A total of 135 patients (65 FL, 45 BC3, 25 BC4) comprised the study groups. The sensitivity and specificity of FS within these three categories were determined. Results In the FL group, 6 of 65 patients were found to have thyroid cancer. Three were identified on frozen section (FS) resulting in a sensitivity and specificity of 50% and 100%, respectively. Thus, FS changed the operation in 3 of 65 cases (4.6%). In the BC3 group, 5 of 45 patients were found to have cancer. One was identified on FS resulting in a sensitivity and specificity of 20% and 100%, respectively. Thus, FS changed the operation in 1 of 45 patients (2.2%). In the BC4 group, 4 of 25 patients were found to have cancer. Two were identified on FS resulting in a sensitivity and specificity of 50% and 100% respectively. Thus, FS changed the operation in 2 of 25 patients (8%). Conclusions There is improved utility of FS in BC 4 patients as 8% avoided reoperation. However, this benefit hinges on surgeon practice regarding the management of differentiated thyroid cancer >1 cm and |
| Databáze: | OpenAIRE |
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