Clinical application of frozen section in thyroid tumor operation
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Objective:To discuss the clinical application of frozen section in thyroid operation so as to raise the rate of correct diagnosis. Methods: A retrospective review was made for 356 frozen sections and paraffin sections. Results: The frozen section diagnosis showed out 309 cases with benign lesion , 36 cases with malignant tumor and there were 11delayed diagnosis ;in the control , the paraffin section showed 314 cases with benign lesion and 42 cases with malignant tumor ; There were 5 false-negative diagnosis dy frozen section (1.4%) and conformed dinagnosis rate of frozen section reached 98.5%. Conclusion: Correct diagnosing rate of frozen section in thyroid may be raised by increasing the section quality and improving the method.Keywords:
Section (typography)
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Objective:To study the pathological diagnosis rate of intraoperative frozen section and to analyze the causes of misdiagnosis and to explore methods to reduce misdiagnosis.Methods:Retrospective analysis were applied to the diagnosis of intraoperative frozen section and paraffin section in 2839 cases of lesions.Results:Compared with paraffin,the total diagnosis rate of frozen section was 96.16%and the diagnosis rate of malignant tumor was 94.74%.The diagnosis rate of benign tumors was 96.73% while the diagnosis rate of borderline tumor was 87.76% with the rate of misdiagnosis being 0.92%.Conclusion:The results suggest that intraoperative frozen section pathological diagnosis is an effective method to determine the nature of the lesions in operation,and has important implications on selecting the appropriate surgical plan.
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In this retrospective study, we compared the accuracy of frozen section and sonographic diagnosis in predicting the final paraffin section diagnosis of ovarian lesions. We hoped thereby to determine if sonographic findings could obviate the need for frozen section in certain circumstances. The frozen section and sonographic diagnosis were compared with the final paraffin section diagnosis to determine whether the lesion was felt to be a benign or malignant tumour. Frozen section diagnosis agreed with final paraffin section diagnosis in 137 (77.4%) cases of primary malignant tumours, 201 (90.1%) cases of metastatic disease and 328 (82%) benign cases. Sonographic results matched final pathology of 133 cases of primary malignancy (75.1%) and 192 cases of metastatic disease (86.1%) and 304 benign cases (76%). Our study indicates that preoperative sonography is accurate enough in differentiating adnexal masses to make the routine use of frozen sections unnecessary.
Adnexal Diseases
Adnexal mass
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Objective To explore the accuracy of the frozen section in diagnosis of breast disease and investigate the method for increasing accuracy.Methods The diagnosis of frozen section and paraffin slice of 1 409 cases was annlyzed retrospectively.Results The percentage of breast frozen section was 72.1% in frozen section,the diagnostic accuracy was 98.93%,13 cases were failed to make a definite diagnosis(0.92%),3 cases were false negative(0.21%).In 1 409 cases breast frozen sections the benign pathologic change versus malignant change was 8.67∶1.Conclusions The major reasons of false and uncertain diagnosis are limitation of sampling and quality of section.It is an accurate method for diagnosis of breast disease.
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Abstract Aim The aim of this study was to evaluate the accuracy of intraoperative frozen section of ovarian tumors and to analyze the factors that influence the accuracy. Material and Methods We compared the frozen section diagnosis of 218 ovarian tumors with their final diagnosis in paraffin sections, over a period of 10 years from 1999 to 2008. Results Results were analyzed on two parameters: (i) status of malignancy and (ii) histological type. The overall accuracy was 95%. The sensitivity for benign, borderline and malignant tumors was 99.3%, 86.66% and 96.3%, respectively. The corresponding specificities were 92.6%, 97% and 100%. Most of the discrepant cases were of borderline category. The overall accuracy for histological diagnosis was 80.7%. The number of sections examined at frozen and paraffin had a statistically significant association with the accuracy of frozen section. Conclusion Frozen section diagnosis is of high quality at our center with a few exceptions in borderline category. The numbers of sections examined have a statistically significant influence on the accuracy of frozen section of ovarian masses.
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Objective To assess the value of frozen section in the diagnosis of thyroid diseases and the reasons of diagnostic errors. Methods A review of 948 frozen sections of thyroid diseases was done by a senior pathologist.The results were compared with that of the paraffin. Results Of the 948 cases reviewed,malignant tumors were confirmed in 312,and benign in 636.The diagnosis made by frozen section was consistent with the paraffin method in 920 cases(97.05%),and that inconsistent(diagnostic errors) with the paraffin found in 18(1.90%),being false-negative missed diagnosis.The diagnosis was delayed in 10(1.05%). Conclusion Frozen section has a great significance in qualitative diagnosis of thyroid diseases at surgery.Accurate material-taking,improvement of slice quality and level of diagnosis are conducive to the accuracy of diagnosis by employing this technique.
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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
Medullary carcinoma
Follicular carcinoma
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Objective : Frozen section evaluation of gynecologic tumors can be used to establish a histopathologic diagnosis and guide the surgeon to perform the appropriate surgical procedure. A retrospective study was conducted to determine the accuracy of frozen section diagnosis of gynecologic tumors. Methods : We compared the result of 459 consecutive gynecologic frozen section diagnosis with their final diagnosis by paraffin sections from January 1996 to August 2001. Results : 459 gynecologic tumors that underwent frozen section evaluation were studied. Frozen section was accurate in 94.9% of 390 ovarian tumors and inaccurate in 5.1%. The sensitivity, specificity, positive predictive value, and negative predictive value for frozen section in ovarian tumors were 86.7%, 97.8%, 84.4%, 97.7%. There was three false-positive and twelve false-negative cases. And frozen section was accurate in 68 of 69 uterine tumors. Conclusion : Frozen section diagnosis has important implications regarding the type and extent of surgery performed at the initial operation and this method can obtain the highest accuracy when there is cooperation between experienced surgeons and reliable, careful pathologists. Most incompatible frozen section diagnosis occurred especially in mucinous ovarian tumor. Performing multiple section is recommended in the frozen section diagnosis of mucinous ovarian tumors.
Section (typography)
Ovarian tumor
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Objective To explore the accuracy of frozen section of uterus specimen in stageⅠendometrial carcinoma. Methods There were 49 cases of stageⅠendometrial carcinoma during the period of January 1991 to December 2000 with coronal section, and to undergo gross, frozen section and paraffin section for diagnosis, The accordance and discrepancy in the results of tumor histology and invasive depth in myometrium were compared. Results The histological types by frozen section were exactly the same as those by paraffin section. The accurate rate in grading by frozen section was 85.71% when compared with paraffin section; The accordance rates in judging the invasive depth in myometrium between gross versus frozen section, frozen section versus paraffin section were 73.47% and 89.80% respectively.Conclusion To select the suspected site carefully will help to improve the diagnostic accuracy of frozen section in stageⅠendomertial carcinoma.
Grading (engineering)
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Objective To analyze the clinical significance of frozen section in breast lesion diagnosis and its causes of diagnostic errors.Methods The diagnosis made by using frozen and paraffin sections in 1 895 cases with diseases of mammary gland was analyzed.Results Of the 1 895 cases,992 were malignant,and 903 benign.A definite diagnosis of frozen sections was1 876 cases(99.00%).The diagnostic errors were found in nine cases(0.47%);delayed diagnosis in 10(0.53%).ConclusionFrozen section diagnosis is of significance of intraoperative qualitation for breast lesions.Improving accuracy of drawing tissues from the lesion and quality of the section making are conducive to raising the accuracy of comfirmation of the conditions.
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Objective To discuss the clinical application of frozen section in thyroid operation so as to raise the rate of correct diagnosis.Methods A retrospective review was made to 248 frozen sections and paraffin sections.Results The frozen section diagnosis showed out 217 cases with benign lesion,22 cases with malignant tumor and there were 9 delayed diagnosis;in the control,the paraffin section showed 220 cases with benign lesion and 28 cases with malignant tumor;There were 3 false-negative diagnosis by frozen section (1.21%) and conformed diagnosis rate of frozen section reached 95.1%.Conclusions The correct diagnosing rate of frozen section in thyroid operation may be raised by increasing the section quality and improving the method.
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