The role of intraoperative frozen sections for thyroid nodules.
The role of intraoperative frozen sections (FS) during thyroidectomy is controversial.


OBJECTIVE
to evaluate the role of FS for thyroid nodules management.


METHODS
All patients who had thyroid surgery for nodular disease and previous USG-guided FNAB in 2006 were prospectively analyzed. They underwent intraoperative FS evaluation, and the biopsy material was classified as benign, malignant or follicular neoplasm. FNAB, FS and paraffin sections were compared.


RESULTS
Under the FS, 54% of the nodules were benign, 30% were follicular neoplasms, and 16% were malignant. All cases considered benign and malignant under the FS evaluation were confirmed through the histological 'paraffin' analysis. Since it is not considered a definitive indication for total thyroidectomy, if the follicular neoplasms were classified as 'benign' under the FS, their sensitivity, specificity, positive and negative predictive values and global diagnostic accuracy were 69%, 100%, 100%, 91,5% e 77%, respectively. Among the 42 cases classified as 'follicular neoplasm' under the FNAB, in 1 case the FS conclusion was for papillary carcinoma, in 3 cases as benign (all confirmed through the 'paraffin'); and 38 cases continued as 'follicular pattern', being 29 follicular adenomas and 9 carcinomas through the 'paraffin'.


CONCLUSIONS
The FS is only indicated when the FNAB reports 'follicular neoplasm'.
Almeida
João Paulo Alves de
JP
Faculdade de Ciências Médicas, Fundação Lusíada, Santos.
Couto Netto
Sergio Dias do
SD
Rocha
Rafael Pinto da
RP
Pfuetzenreiter
Elio G
EG
Dedivitis
Rogério Aparecido
RA
D044963:Biopsy, Fine-Needle / Q000592:standards*; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000601:surgery; D005629:Frozen Sections; D006801:Humans; D007432:Intraoperative Period; D008198:Lymph Nodes / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012016:Reference Values; D016606:Thyroid Nodule / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy