A comparative study of the intraoperative rapid frozen section and postoperative paraffin section in the dignosis of thyroid carcinoma

Abstract

Objective To study the value of intraoperative rapid frozen section in the diagnosis of thyroid cancer. Methods Ninety-seven patients who underwent thyroid lesions surgery were selected. Thyroid tissues were cut during operation from all patients to make rapid frozen sections, and paraffin sections were made from the remaining tissues. The diagnosis results of benign and malignant thyroid were compared between intraoperative rapid frozen sections method and postoperative paraffin sections method. The consistency of two methods in the diagnosis of different types of thyroid cancers was analysed. Results In the 97 patients, 32 cases were malignant and 65 cases were benign confirmed by paraffin sections; 66 cases were benign, 29 cases were malignant confirmed by introperative rapid frozen section and diagnoses of 2 cases were delayed. The accuracy of intraoperative rapid frozen section was 95.88% (93/97) in the differential diagnosis of benign and malignant thyroid lesions, and there was no significant difference in accuracy between the two methods (P>0.05). Among the 32 cases of malignant lesions, 26 cases (81.25%) of papillary carcinoma, 4 cases (12.50%) of follicular carcinoma and 2 cases of medullary carcinoma (6.25%) were confirmed by paraffin section. One case of papillary carcinoma was misdiagnosed by intraoperative rapid frozen section; for the follicular carcinoma, 1 case was misdiagnosed and 1 case was delayed in diagnosis by intraoperative rapid frozen section. The consistency of the two methods in the diagnosis result was good (K=0.84). Conclusions Intraoperative rapid frozen sections has high consistency to postoperative paraffin section in the diagnosis of thyroid carcinoma, and its production time is short, and diagnostic accuracy is high, which can help to provide useful information for surgery. Fully preparation, careful drawing, prudent production and mastering pathological features of benign and malignant thyroid lesions can further improve the accuracy of rapid frozen section in the diagnosis of thyroid carcinoma. Key words: Thyroid carcinoma; Intraoperative rapid frozen section; Postoperative paraffin section; Diagnosis