The evaluation of thyroid nodules is routine use of frozen section examination necessary followingpreoperative fine needle aspiration biopsy

Abstract

Ameliyat öncesi ince i¤ne aspirasyon biyopsisi (‹‹AB) sonuçlar›n› tek parametre olarak kullanarak tiroidektominin geniflli¤ine karar verilip verilemeyece¤i ve frozen section incelemesinin her olguda rutin olarak gerekip gerekmedi¤i araflt›r›ld›. Hastalar ve Yöntemler: Çal›flmaya nodüler tiroit tan›s›yla tiroidektomi ameliyat› yap›lan ve ameliyat öncesinde ince i¤ne aspirasyonu (n=46) ve/veya ameliyat s›ras›nda frozen section (n=40) sonuçlar›na ula- fl›labilen 67 hasta (40 kad›n, 27 erkek; ort. yafl 44; da¤›l›m 17-78) al›nd›. ‹ki yöntemin sonuçlar›yla patolojik inceleme sonuçlar› karfl›laflt›r›ld›. Bulgular: Histopatolojik sonuçlar 25 olguda (%37.3) malign, 42 olguda (%62.7) benign bulundu. ‹nce i¤- ne aspirasyon biyopsisinin duyarl›l›¤› %50, özgüllü- ¤ü %95, tan›sal do¤ruluk oran› %77; frozen section incelemesinin duyarl›l›¤› %100, özgüllü¤ü %87, tan›- sal do¤rulu¤u %91 bulundu. Sonuç: Bulgular›m›z, ‹‹AB’nin düflük duyarl›l›k ve tan›- sal do¤ruluk de¤erleri nedeniyle, klinik malignensi parametrelerinin dikkatle de¤erlendirilmesi ile birlikte rutin frozen section incelemesinin gerekli oldu¤unu göstermektedir.

We evaluated the role of fine-needle aspiration biopsy as a single parameter in determining the extent of thyroidectomy and the necessity of routine use of frozen-section examination in patients with nodular thyroid disease. Pat i ents and Methods: We reviewed 67 patients (40 females, 27 males; mean age 44 years; range 17 to 78 years) who underwent thyroidectomy for nodular thyroid disease. Preoperative fine-needle aspiration biopsy and intraoperative frozen-section examination were performed in 46 patients and 40 patients, respectively. The results were compared with histopathologic diagnoses. Results: Histopathologically, 25 patients (37.3%) had malignant and 42 patients (62.7%) had benign disease. The sensitivity, specificity, and diagnostic accuracy were 50%, 95%, and 77% for fine-needle aspiration biopsy, and 100%, 87%, and 91% for frozen-section examination, respectively. Conclusion: In view of lower sensitivity and accuracy rates for fine-needle aspiration biopsy, the routine use of frozen-section examination seems to be necessary especially in cases with highly suggestive clinical findings of malignancy.