Retrospective analysis of diagnosis by intraoperative frozen section and routine paraffin embedded tissue in 638 thyroid disease patients

Abstract

OBJECTIVE To summarize a common pathogenetic condition, the pathologic characteristics shown in frozen section and our experience utilizing 2 different diagnostic methods in cases of common thyroid diseases (TD). METHODS Data from 638 cases with frozen sections from thyroid tissue were retrospectively analyzed. The intraoperative frozen sections of the patients and postoperative diagnostic results of routine paraffin sections were compared. RESULTS In the 683 patients, the gender ratio of females to males was 2.64 : 1, and the ratio between the patients with nodular goiter (NG) and the patients with thyroid adenoma was 1.5 : 1. The oldest age group of patients with thyroid cancer (TC) ranged from 40 to 49 years. Frozen section pathologic examination has been employed more and more in the diagnosis of thyroid diseases, and the detection rate of TC has increased year by year, i.e., the rate increased to 6.45%, 7.58%, 14.55% and 16.57%, respectively, in 2005, 2006, 2007 and 2008. Thyroid papillary carcinoma (TPC) was the most commonly seen malignant tumor of the thyroid(MTT), which accounted for approximately 94.8% of MTTs and 11.44% of the total TDs. Micropapillary carcinoma accounted for 27.4% of TPC, and multifocal carcinomas accounted for 15.58% of TCs. Many of the TCs (19.48%) were complicated by benign diseases such as adenoma, NG and thyroiditis. The coincidence rate of diagnoses made by frozen section and paraffin embedding for thyroid disease was 98.59%. Calcification was rather common in NG and TPC, and there were signifi cant di ff erences in psammoma bodies (PMB) between the calcifications of TPC and NG ( P < 0.01). CONCLUSION TPC ranks first in the incidence of MTTs and accounts for 94.8% of all MTTs. About 1/4 of TPCs are micropapillary carcinoma, while 1/5 are accompanied by benign disease, such as adenoma, NG and thyroiditis. PMB are of importance and of signi fi cance in the diagnosis of TPC.