Intraoperative frozen section performance for thyroid cancer diagnosis
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/239866 |
Resumo: | Objective: A primary medical relevance of thyroid nodules consists of excluding thyroid cancer, present in approximately 5% of all thyroid nodules. Fine-needle aspiration biopsy (FNAB) has a paramount role in distinguishing benign from malignant thyroid nodules due to its availability and diagnostic performance. Nevertheless, intraoperative frozen section (iFS) is still advocated as a valuable tool for surgery planning, especially for indeterminate nodules. Subjects and methods: To compare the FNAB and iFS performances in thyroid cancer diagnosis among nodules in Bethesda Categories (BC) I to VI. The performance of FNAB and iFS tests were calculated using final histopathology results as the gold standard. Results: In total, 316 patients were included in the analysis. Both FNAB and iFS data were available for 272 patients (86.1%). The overall malignancy rate was 30.4%% (n = 96). The FNAB sensitivity, specificity, and accuracy for benign (BC II) and malignant (BC V and VI) were 89.5%, 97.1%, and 94.1%, respectively. For all nodules evaluated, the iFS sensitivity, specificity, and accuracy were 80.9%, 100%, and 94.9%, respectively. For indeterminate nodules and follicular lesions (BC III and IV), the iFS sensitivity, specificity, and accuracy were 25%, 100%, and 88.7%, respectively. For BC I nodules, iFS had 95.2% of accuracy. Conclusion: Our results do not support routine iFS for indeterminate nodules or follicular neoplasms (BC III and IV) due to its low sensitivity. In these categories, iFS is not sufficiently accurate to guide the intraoperative management of thyroidectomies. iFS for BC I nodules could be an option and should be specifically investigated. |
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Goemann, Iuri MartinPaixão, Francisco CostaMigliavaca, AlceuGuimaraes, Jose RicardoScheffel, Rafael SelbachMaia, Ana Luiza Silva2022-06-07T04:40:42Z20222359-3997http://hdl.handle.net/10183/239866001141046Objective: A primary medical relevance of thyroid nodules consists of excluding thyroid cancer, present in approximately 5% of all thyroid nodules. Fine-needle aspiration biopsy (FNAB) has a paramount role in distinguishing benign from malignant thyroid nodules due to its availability and diagnostic performance. Nevertheless, intraoperative frozen section (iFS) is still advocated as a valuable tool for surgery planning, especially for indeterminate nodules. Subjects and methods: To compare the FNAB and iFS performances in thyroid cancer diagnosis among nodules in Bethesda Categories (BC) I to VI. The performance of FNAB and iFS tests were calculated using final histopathology results as the gold standard. Results: In total, 316 patients were included in the analysis. Both FNAB and iFS data were available for 272 patients (86.1%). The overall malignancy rate was 30.4%% (n = 96). The FNAB sensitivity, specificity, and accuracy for benign (BC II) and malignant (BC V and VI) were 89.5%, 97.1%, and 94.1%, respectively. For all nodules evaluated, the iFS sensitivity, specificity, and accuracy were 80.9%, 100%, and 94.9%, respectively. For indeterminate nodules and follicular lesions (BC III and IV), the iFS sensitivity, specificity, and accuracy were 25%, 100%, and 88.7%, respectively. For BC I nodules, iFS had 95.2% of accuracy. Conclusion: Our results do not support routine iFS for indeterminate nodules or follicular neoplasms (BC III and IV) due to its low sensitivity. In these categories, iFS is not sufficiently accurate to guide the intraoperative management of thyroidectomies. iFS for BC I nodules could be an option and should be specifically investigated.application/pdfengArchives of endocrinology and metabolism. São Paulo. Vol. 66, no. 1 (2022), p. 50-57Nódulo da glândula tireóideBiópsia por agulha finaSecções congeladasNeoplasias da glândula tireóideThyroid cancerIntraoperative frozen sectionBethesda classificationThyroid nodulesIntraoperative frozen section performance for thyroid cancer diagnosisinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001141046.pdf.txt001141046.pdf.txtExtracted Texttext/plain33957http://www.lume.ufrgs.br/bitstream/10183/239866/2/001141046.pdf.txtd474ac448709698b0f76acd6a9ab4729MD52ORIGINAL001141046.pdfTexto completo (inglês)application/pdf654364http://www.lume.ufrgs.br/bitstream/10183/239866/1/001141046.pdfe3a9ec154faafcabce68f0937c5c4df3MD5110183/2398662023-06-07 03:41:00.146217oai:www.lume.ufrgs.br:10183/239866Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-06-07T06:41Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Intraoperative frozen section performance for thyroid cancer diagnosis |
title |
Intraoperative frozen section performance for thyroid cancer diagnosis |
spellingShingle |
Intraoperative frozen section performance for thyroid cancer diagnosis Goemann, Iuri Martin Nódulo da glândula tireóide Biópsia por agulha fina Secções congeladas Neoplasias da glândula tireóide Thyroid cancer Intraoperative frozen section Bethesda classification Thyroid nodules |
title_short |
Intraoperative frozen section performance for thyroid cancer diagnosis |
title_full |
Intraoperative frozen section performance for thyroid cancer diagnosis |
title_fullStr |
Intraoperative frozen section performance for thyroid cancer diagnosis |
title_full_unstemmed |
Intraoperative frozen section performance for thyroid cancer diagnosis |
title_sort |
Intraoperative frozen section performance for thyroid cancer diagnosis |
author |
Goemann, Iuri Martin |
author_facet |
Goemann, Iuri Martin Paixão, Francisco Costa Migliavaca, Alceu Guimaraes, Jose Ricardo Scheffel, Rafael Selbach Maia, Ana Luiza Silva |
author_role |
author |
author2 |
Paixão, Francisco Costa Migliavaca, Alceu Guimaraes, Jose Ricardo Scheffel, Rafael Selbach Maia, Ana Luiza Silva |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Goemann, Iuri Martin Paixão, Francisco Costa Migliavaca, Alceu Guimaraes, Jose Ricardo Scheffel, Rafael Selbach Maia, Ana Luiza Silva |
dc.subject.por.fl_str_mv |
Nódulo da glândula tireóide Biópsia por agulha fina Secções congeladas Neoplasias da glândula tireóide |
topic |
Nódulo da glândula tireóide Biópsia por agulha fina Secções congeladas Neoplasias da glândula tireóide Thyroid cancer Intraoperative frozen section Bethesda classification Thyroid nodules |
dc.subject.eng.fl_str_mv |
Thyroid cancer Intraoperative frozen section Bethesda classification Thyroid nodules |
description |
Objective: A primary medical relevance of thyroid nodules consists of excluding thyroid cancer, present in approximately 5% of all thyroid nodules. Fine-needle aspiration biopsy (FNAB) has a paramount role in distinguishing benign from malignant thyroid nodules due to its availability and diagnostic performance. Nevertheless, intraoperative frozen section (iFS) is still advocated as a valuable tool for surgery planning, especially for indeterminate nodules. Subjects and methods: To compare the FNAB and iFS performances in thyroid cancer diagnosis among nodules in Bethesda Categories (BC) I to VI. The performance of FNAB and iFS tests were calculated using final histopathology results as the gold standard. Results: In total, 316 patients were included in the analysis. Both FNAB and iFS data were available for 272 patients (86.1%). The overall malignancy rate was 30.4%% (n = 96). The FNAB sensitivity, specificity, and accuracy for benign (BC II) and malignant (BC V and VI) were 89.5%, 97.1%, and 94.1%, respectively. For all nodules evaluated, the iFS sensitivity, specificity, and accuracy were 80.9%, 100%, and 94.9%, respectively. For indeterminate nodules and follicular lesions (BC III and IV), the iFS sensitivity, specificity, and accuracy were 25%, 100%, and 88.7%, respectively. For BC I nodules, iFS had 95.2% of accuracy. Conclusion: Our results do not support routine iFS for indeterminate nodules or follicular neoplasms (BC III and IV) due to its low sensitivity. In these categories, iFS is not sufficiently accurate to guide the intraoperative management of thyroidectomies. iFS for BC I nodules could be an option and should be specifically investigated. |
publishDate |
2022 |
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2022-06-07T04:40:42Z |
dc.date.issued.fl_str_mv |
2022 |
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2359-3997 |
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001141046 |
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http://hdl.handle.net/10183/239866 |
dc.language.iso.fl_str_mv |
eng |
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dc.relation.ispartof.pt_BR.fl_str_mv |
Archives of endocrinology and metabolism. São Paulo. Vol. 66, no. 1 (2022), p. 50-57 |
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