Assessment of the Role of Intraoperative Frozen Section in Confirmation of Papillary Thyroid Carcinoma Metastasis during Thyroidectomies | ||||
The Egyptian Journal of Hospital Medicine | ||||
Article 137, Volume 100, Issue 1, July 2025, Page 3507-3512 PDF (259.5 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/ejhm.2025.445984 | ||||
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Abstract | ||||
Background: When papillary thyroid cancer is first found, it often has lymphatic spread. However, there is still disagreement about the value of preventative central cervical lymph node removal in people with papillary thyroid cancer. Most doctors agree that when there is cervical lymphadenopathy, the first thyroidectomy should include removal of the central cervical lymph nodes. This needs a correct proof of the papillary thyroid cancer spread diagnosis during surgery using a frozen piece. Objective: This study aimed to figure out what part and how important it is to use a surgical frozen section biopsy to find metastases in papillary cervical lymph nodes so that needless central cervical lymph node neck dissections don't happen. Patients and methods: Forty patients from the General Surgery Department and the Endocrine Unit at Ain Shams University Hospitals took part in the study. Examinations for diagnosis and grading were done according to the usual procedure used at Ain Shams University Hospitals. Results: About 40 of the patients in our study who had negative fine needle aspiration cytology (FNAC) from lymph nodes had a frozen section done during surgery. About 21 patients tested positive for cancerous lymph nodes (52.5%) and had a central neck dissection. On the other hand, 19 patients tested negative for malignant lymph nodes (47.5%) and the central neck dissection was not done. This means that the procedure was 87.5% sensitive and 100% specific. After surgery, a paraffin slice showed that 24 patients had cancerous lymph nodes and 16 patients did not. This means that the test was 87.5% sensitive and 100% specific. So, the frozen section of the cervical lymph nodes during surgery is still very important for cutting down on the number of useless central neck dissections and the problems that can come up with them. Conclusion: The frozen section of the lymph nodes during surgery's main purpose was to sort patients into those who really need surgery, lowering the number of useless central neck dissections and the risks that come with them. Along with that, frozen section had a high sensitivity and specificity rate that helped keep interventions from being too strong. The study's biggest flaw was that there were no enough subjects. A study with a bigger group of people would help us understand this similarity better. | ||||
Keywords | ||||
Papillary thyroid cancer; Lymph node metastasis; frozen section | ||||
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