title: Role of frozen section analysis in nodular thyroid pathology.
abstract: BACKGROUND
  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.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institut Universitaire de la Face et du Cou, Avenue de Valombrose, 06100 Nice, France. Electronic address: guevara.n@chu-nice.fr.
authors.forename: N
authors.initials: N
authors.lastname: Guevara
authors.affiliation: Laboratoire de Pathologie Clinique et Expérimentale (LPCE), Hôpital Pasteur, Centre Hospitalo-Universitaire, Voie Romaine BP 69, 06002 Nice, France; Tumorothèque-Centre de Ressources Biologiques Hôpital Pasteur, Centre Hospitalo-Universitaire, Voie Romaine BP 69, 06002 Nice, France.
authors.forename: S
authors.initials: S
authors.lastname: Lassalle
authors.affiliation: Laboratoire de Pathologie Clinique et Expérimentale (LPCE), Hôpital Pasteur, Centre Hospitalo-Universitaire, Voie Romaine BP 69, 06002 Nice, France.
authors.forename: G
authors.initials: G
authors.lastname: Benaim
authors.affiliation: Service d'Endocrinologie, Hôpital L'Archet, Route de Saint-Antoine, 06200 Nice, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Sadoul
authors.affiliation: Institut Universitaire de la Face et du Cou, Avenue de Valombrose, 06100 Nice, France.
authors.forename: J
authors.initials: J
authors.lastname: Santini
authors.affiliation: Laboratoire de Pathologie Clinique et Expérimentale (LPCE), Hôpital Pasteur, Centre Hospitalo-Universitaire, Voie Romaine BP 69, 06002 Nice, France; Tumorothèque-Centre de Ressources Biologiques Hôpital Pasteur, Centre Hospitalo-Universitaire, Voie Romaine BP 69, 06002 Nice, France.
authors.forename: P
authors.initials: P
authors.lastname: Hofman
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D044963:Biopsy, Fine-Needle / Q000379:methods*; D002291:Carcinoma, Papillary / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D005602:France / Q000453:epidemiology; D005629:Frozen Sections / Q000379:methods*; D006801:Humans; D015994:Incidence; D018579:Patient Selection; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D016606:Thyroid Nodule / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy
keywords: Biobank resource center; Fine-needle aspiration cytology; Frozen section; Molecular biology; Surgery; Thyroid