갑상선 결절의 수술 전 세침흡인세포검사 결과에 따라 수술 중 동결절편검사를 생략할 수 있는가?

송정윤; 봉준우; 장재훈; 한상아; Song

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자료유형: 학술저널

저자정보: 송정윤 봉준우 장재훈 한상아 Song

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제15권 제4호

발행연도: 2015.1

수록면: 79 - 85 (7page)

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Purpose: Fine needle aspiration (FNA) is a useful preoperative diagnostic tool for thyroid nodule because of the high sensitivity and specificity. The aim of this study is to determine the necessity of intraoperative frozen section (IOFS) after fine needle aspiration.Methods: Data of 534 patients with a single thyroid nodule who underwent thyroidectomy from June 2006 to August 2013 were reviewed retrospectively. FNA was performed preoperatively in all patients and IOFS was performed selectively according to the intraoperative findings and FNA results. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNA and IOFS for malignant nodules were analyzed.Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FNA for malignant nodules were 100%, 95.5%, 99.8%, 100%, and 99.8%, respectively. All nodules diagnosed as benign by FNA were reaffirmed as benign nodules by permanent sections. When the result of FNA was suspicious for malignancy, specific features of preoperative ultrasound, including hypoechoic, size＜10 mm showed high positive predictive value and accuracy (98%, 86.9%, and 100%, 78.7% respectively).Conclusion: Performance of IOFS was not necessary when the result of FNA was consistent with malignancy or benign. However when the result of FNA was non-diagnostic or atypia, IOFS should be performed for more accurate detection of malignancy. When the result of FNA is suspicious for malignancy, IOFS is restrictively useful for excluding benign nodules using the features of ultrasound. In addition, IOFS is not useful in finding malignant thyroid nodules when the result of FNA is follicular neoplasm.

#세침흡인검사 #동결절편검사 #갑상선 절제술 #정확도 #Fine needle aspiration #Intraoperative frozen section #Thyroidectomy #Accuracy

참고문헌 (21)

참고문헌 신청

Agcaoglu O / 2013 / Factors that affect the false-negative outcomes of fine-needle aspiration biopsy in thyroid nodules / Int J Endocrinol 2013 : 126084 ~

Boyd LA / 1998 / Preoperative evaluation and predictive value of fine-needle aspiration and frozen section of thyroid nodules / J Am Coll Surg 187 : 494 ~ 502

Cappelli C / 2007 / The predictive value of ultrasound findings in the management of thyroid nodules / QJM 100 : 29 ~ 35

Chang HY / 1997 / Correlation of fine needle aspiration cytology and frozen section biopsies in the diagnosis of thyroid nodules / J Clin Pathol 50 : 1005 ~ 1009

Chen H / 1995 / Follicular lesions of the thyroid. Does frozen section evaluation alter operative management? / Ann Surg 222 : 101 ~ 106

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