[Comparison between the diagnostic accuracy in diagnosis of thyroid nodules with fine needle biopsy an intraoperative histological evaluation of frozen tissue].
BACKGROUND
The aim of this study was to compare the diagnostic accuracy of fine needle biopsy (FNB) and intraoperative frozen-section biopsy (FS) regarding the surgical management of thyroid nodules.


METHODS
A total of 812 patients with solitary nodule or dominant nodule in a multinodular goiter were evaluated. The patients underwent preoperative FNB and intraoperative FS diagnosis.


RESULTS
The definitive histological diagnosis (HD) was: i) 222 malignant lesions (118 papillary, 67 follicular, 16 anaplastic and 8 medullary cancers); ii) 590 benign lesions. FNB accuracy was 90.6%, sensitivity 96.8% and specificity 87.1%. FS accuracy was 97.4%, sensitivity 91.3% and specificity 100%. False negative (FN) were 10 for FNB and 21 for FS. False positive (FP) were 74 for FNB and 0 for FS. FS was less sensitive for the diagnosis of papillary cancer (more FN) and more specific for the diagnosis of follicular thyroid cancers (no FP).


CONCLUSIONS
In conclusion, FS is useful in patients undergoing surgery for a thyroid nodule having a "suspicious" cytology. It adds no information in patients with an FNB diagnosis of malignancy and is of limited use in those in whom an FNB benign lesion is diagnosed.
Morosini
P P
PP
Servizio di Citopatologia, USL 7, Ospedale Regionale, Ancona.
Mancini
V
V
Filipponi
S
S
Taccaliti
A
A
Ferretti
M
M
Gusella
P
P
Vecchi
A
A
Fianchini
A
A
Fabris
G
G
D006801:Humans; D007432:Intraoperative Period; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000473:pathology; D016606:Thyroid Nodule / Q000473:pathology*