Determining the Value of Intra-Operative Frozen Section in Thyroid Neoplasm Management

 

The purpose of this study is to evaluate the value of the frozen section (FS) in the management of patients with thyroid disease, as well as to share our personal experiences with it after thyroid surgery.

In this retrospective investigation, the outcomes of 1110 frozen sections of thyroid tissues analysed during a ten-year period from 2003 to 2012, as well as their linkages with the final histological evaluation, were examined. Deferred replies were not taken into account in statistical calculations.

Results: In our investigation, FS and the final histological diagnosis concurred in 85.4 percent of patients, whereas 5.5 percent differed. 9.1% of the cases were placed on hold. The global specificity and sensitivity of FS analysis were 99.3 percent and 64.7 percent, respectively, for all histological subtypes. It detected papillary cancer with a 61.7 percent sensitivity, follicular carcinoma with an 83.3 percent sensitivity, and anaplastic carcinoma with a 100 percent sensitivity. The disparities were caused by six false-positive (FP) diagnoses and 55 false-negative (FN) diagnoses. Fifty percent of the FN was papillary microcarcinoma. The FS exam has a positive predictive value (PPV) of 94.4 percent and a negative predictive value of 93.9 percent (NPV).

Conclusions: The utility of intraoperative FS in the confirmation of thyroid nodule malignancy is supported by our findings. It’s associated with good specificity and a reasonable sensitivity rate. The majority of the inconsistencies between FS and ultimate histological diagnosis were explained by papillary microcarcinoma. Pathologists and surgeons could benefit from a standardised language in their evaluations and decision-making in the operating room.


Author(S) Details

Nihed Abdessayed
Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia.

Raja Jouini
Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia.

Wafa Koubba-Mahjoub
Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia.

Ehsen ben Brahim
Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia.

Achraf Chadli Debbiche
Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia.

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