Intraoperative cytology as an additional method for detecting papillary thyroid carcinoma
Background. Timely detection of papillary thyroid carcinoma (PTC) is very important, because the algorithm for patient’s treating depends on this. The main and effective method for preoperative diagnosis of PTC is a fine needle aspiration (FNA). At the same time, it is not always possible to clearly identify PTC at this stage. Intraoperative frozen section examinations (FSE) often help to solve this problem, but they are not always effective. Therefore, it is relevant to search for additional methods to detect thyroid cancer, and intraoperative cytology (IC) can be considered as one of them. The purpose of the study was to evaluate the effectiveness of IC as an additional method for the detection of PTC. Materials and methods. IC was performed in 213 cases of thyroid lesions, and its results were compared with FSE, taking into account the conclusions of FNA, which were classified in accordance with the Bethesda system for reporting thyroid cytopathology. Results. Among the analyzed cases, there were 127 PTC, in which it was not possible to clearly identify the carcinoma with FNA. A comparison of the IC and FSE results showed that in case of non-encapsulated PTC, the efficiency of FSE was 100 %, so IC only duplicated them. However, for encapsulated PTC, the efficiency of IC and FSE was similar: 18 of 81 (22.2 %) and 20 of 81 (24.7 %), respectively. At the same time, the use of the IC allowed to identify 7 more PTC: 5 of 34 (14.7 %) in the FNA category “suspicion of carcinoma”, 1 of 30 (3.3 %) — “follicular neoplasm”, in the categories “atypia/benign process” — 1 of 17 (5.9 %). Conclusions. In case of encapsulated thyroid lesions, the comprehensive implementation of both FSE and IC helps to improve the efficiency of intraoperative diagnosis of PTC.
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