Quantitative Frozen Biopsy of Central Metastasis in PTC

Abstract

Objective: Nodal metastasis in PTC occurs in the central compartment of the ipsilateral neck and spreads laterally. Occult lateral neck metastasis can be predictable by lymphatic status of central compartment. This study was to evaluate the diagnostic accuracy of frozen biopsy for quantitative nodal evaluation of central neck metastasis.

Method: A total of 264 patients with papillary thyroid cancer underwent total thyroidectomy with central compartment neck dissection as an initial operation. All fresh tissues from ipsilateral central neck dissection were examined by frozen biopsy for central neck metastasis with quantitative nodal analysis.

Results: Among them, 134 patients (51% [134/262]) had central neck metastasis. The sensitivity and specificity of frozen biopsy for the detection of central neck metastasis were 100% and 99.2% in 264 patients who underwent total thyroidectomy with bilateral central neck dissection. The diagnostic accuracy for the number of metastatic ipsilateral central lymph nodes was 85.8% compared with permanent biopsy in 134 patients who had central neck metastasis.

Conclusion: Frozen biopsy for quantitative analysis of central compartment is a precise tool for intraoperative evaluation of central lymphatic status and would also be helpful for prediction of nodal involvement of lateral neck.