[show abstract][hide abstract] ABSTRACT: The aim of the study was to determine folate reserve in patients with thyroid and breast diseases. Erythrocyte folate concentrations of ninety-eight patients and thirty healthy subjects were determined by a modified micro-biological assay. An increase in folate levels was observed in of both thyroid (n = 15) and breast (n = 22) cancer patients compared to controls, while a decrease was observed in benign breast disease patients (n = 24) compared to both control group and breast cancer patients. Patients with benign thyroid diseases (n = 37) had significantly lower folate concentrations as compared to both control and thyroid cancer groups. The results pointed out the elevated erythrocyte folate levels in the patients with malignant tumors.
[show abstract][hide abstract] ABSTRACT: Phyllodes tumor (PT) is a rare neoplasm comprising less than 1% of all breast tumors. Its clinical spectrum ranges from a benign and locally recurrent form of behavior to malignant and metastatic forms. The aim of the study was to evaluate the clinical characteristics, treatment regimens, survival and late complications in patients with PT.
We retrospectively reviewed the medical records of 10 women who were treated for PT in our center between 1998 and 2002. All cases were histologically examined by an experienced breast pathologist, and tumors were classified as benign, borderline malignant or malignant according to standard histological criteria.
The median age at diagnosis was 45.5 years (range: 21-69 years). Seven (70%) of 10 tumors were benign and 3 (30%) were malignant. The median tumor size was 29 mm (range: 12-80 mm). The least safe margin was 1 cm. Three of 10 patients had malignant PT and underwent simple mastectomy. Local recurrence was determined in no patients. Only one patient had lung metastasis. Median follow-up period was 62 months (range, 12-96 months). The patient with lung metastasis was treated with doxorubicine but died one year after the operation.
PT is a rare neoplasm of the breast. It resembles fibroadenoma. Local excision with appropriate surgical margins seems adequate in all patients (Tab. 1, Fig. 3, Ref. 15). Full Text (Free, PDF) www.bmj.sk.
Bratislavske lekarske listy 01/2010; 111(5):271-4. · 0.47 Impact Factor
[show abstract][hide abstract] ABSTRACT: Breast ductoscope is a fiberoptic endoscope used for examining the distal breast ducts under direct vision in order to identify the source of pathologic nipple discharge. The purpose of this study was to investigate the reliability of intra-operative breast ductoscopy in patients with pathologic nipple discharge, which could not be identified by radiologic tests. Between April 2002 and March 2007, breast ductoscopy was performed in 34 patients who had pathologic nipple discharge with no radiologic evidence about the source. The procedures were carried out under general anesthesia and ductoscopic findings were as well as the histopathology of the specimens were recorded and documented. In 88%, (30 of 34) of the patients, endoscope was successfully introduced into the external orifice of the ducts at the nipple and proximal breast ducts were successfully visualized. Ductoscopy revealed intraductal lesions (i.e., ductal obstruction, intraductal papilloma, red patches, and erythematoid platter) in 20 patients (66%). Among the 20 patients with visible endoluminal pathology, nine had a papilloma and eight had signs of either acute inflammation (bleeding, erythema) or previous inflammation with healing (adhesions and blocked ducts). In two cases, invasive breast carcinoma was identified, one of which was ductal carcinoma in situ (DCIS) with minimal invasion. In both cases, there had been blocked ducts. In one case DCIS was identified. Breast ductoscopy is a reliable and easy-to-use method to demonstrate the source of pathologic nipple discharge in cases with bleeding and other intraductal lesions.
The Breast Journal 06/2009; 15(4):329-32. · 1.83 Impact Factor
[show abstract][hide abstract] ABSTRACT: Tryptophan degradation metabolites are known to suppress T-cell function, which is a mechanism of resistance of tumor cells against immune surveillance. The aim of this study was to evaluate tryptophan degradation along with serum neopterin levels in benign and malignant breast disease. Serum tryptophan and kynurenine levels and neopterin concentrations of 30 patients with malignant and 27 patients with benign breast disease were determined by HPLC and ELISA, respectively. The slight increase in tryptophan degradation in a subgroup of cancer patients with higher grade tumors was not statistically significant, but the increased degradation was correlated with higher neopterin concentrations. Neopterin levels in patients with malignant breast disease were significantly higher than in the benign group (p<0.05). Tryptophan degradation positively correlates with the aggressiveness of the tumor because it changes with tumor grade rather than disease stage.
The International journal of biological markers 01/2009; 24(4):265-70. · 1.59 Impact Factor
[show abstract][hide abstract] ABSTRACT: YKL-40 is a growth factor for connective tissue cells; it also stimulates the migration of endothelial cells. YKL-40 is secreted by cancer cells, and elevated serum levels have been associated with poorer prognosis in metastatic breast cancer. In the present study we evaluated the prognostic role of serum YKL-40 levels in patients with locally advanced breast cancer.
YKL-40 levels were measured using ELISA in serum samples obtained from 45 breast cancer patients prior to surgery and chemotherapy. The median follow-up time was 46 months (range, 10-96 months). All patients underwent surgery after chemotherapy. During the follow-up period, 21 patients relapsed and there were 17 deaths.
The median serum YKL-40 concentration in patients with locally advanced breast cancer was 149.5 mug/l (range, 25.0-1021.3 microg/l). This was higher than levels observed in healthy female controls but the difference was not significant (P=0.44). Serum YKL-40 levels were also higher in patients with tumour size >2 cm and node-positive disease but again the differences were not significant (P>0.05). Tumour volume was correlated with serum YKL-40 levels (r=0.308, P=0.039). High serum YKL-40 levels were associated with shorter disease-free and overall survival although this trend failed to reach significance (P>0.05). Multivariate analysis including tumour size, lymph node status, oestrogen and progesterone receptor status, tumour grade, and serum YKL-40 levels indicated that serum YKL-40 levels were an independent prognostic variable for overall survival (hazard ratio, 1.004; 95% confidence intervals: 1.00, 1.07; P=0.027). Tumour size, lymph node status and oestrogen receptor status were also independent prognostic variables for overall survival (P<0.05).
Our results show that serum levels of the growth factor YKL-40 may be a useful prognostic indicator of outcome for patients with locally advanced breast cancer. Further studies are required to fully elucidate the biological function of YKL-40 in breast cancer.
Advances in Therapy 08/2008; 25(8):801-9. · 2.13 Impact Factor
[show abstract][hide abstract] ABSTRACT: DNA sequence variations in hypoxia-inducible factor-1alpha (HIF-1alpha) gene, which have been demonstrated to be correlated with tumor angiogenesis, may yield changes both in the production outcomes and in the activities of the gene. In this study, we investigated the relationship between three single nucleotide polymorphisms (SNPs) [C1772T and G1790A in exon 12 and C111A in exon 2 of the HIF-1alpha gene] in the HIF-1alpha gene coding regions and development of sporadic breast cancer in the Turkish population. These three polymorphisms result in an amino acid change from proline 582 to serine, from alanine 588 to threonine and from serine 28 to tyrosine, respectively.
Genomic DNA was isolated from 102 sporadic breast cancer patients and 102 healthy female controls. All three HIF-1alpha gene regions were amplified by PCR, and genotypes were determined by RFLP and DNA sequencing.
There were no significant differences between patients and controls in terms of the distribution of C1772T and G1790A polymorphisms of HIF-1 gene (p >0.05). As for HIF-1alpha C111A polymorphism, we did not find CA and AA variants of the gene in either controls or patients. Multivariable logistic regression analysis was performed between CC and CT + TT genotypes of C1772T polymorphism. No significant differences were found between these two genotypes in terms of clinicopathological characteristics of the patients including age at enrollment, age at menarche and first delivery, number of full-term pregnancies, body mass index, use of oral contraceptives and postmenopausal hormones, family history of breast and ovarian cancers, menopausal status, histopathological features, oophorectomy, smoking habits, and alcohol consumption (p >0.05).
Our results suggest that none of the polymorphisms studied in the HIF-1alpha gene influence susceptibility to sporadic breast cancer. The present study is the first case-control study that investigates the association of HIF-1alpha polymorphisms with sporadic breast cancer in the Turkish population.
Archives of Medical Research 05/2008; 39(3):338-45. · 2.08 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of the present study was to evaluate the relationship between the levels of neopterin among patients with benign and malignant breast disease and the relation with the stage of the malignant process. In this study, neopterin concentrations and enzyme activities of superoxide dismutase (SOD) and catalase (CAT) were deter-mined in malign (n=30) and benign breast tumor patients (n=30) by high performance liquid chromatographic and spectrophotometric methods, respectively. Results were compared with a healthy control group (n=20). The correlations between neopterin, CAT and SOD were also evaluated in controls and patients. Urinary neopterin level of the control group was (mean value ± S.D.) 128.6 ± 64.6 µmol/mol creatinine. Neopterin concentrations in patients with breast malignancy were 153.6 ± 71.2 µmol/mol creatinine and 107.8 ± 32.1 µmol/mol creatinine in benign disorders patients. The mean neopterin level in the benign group was found to be statistically different from the malign tumor group (p = 0.039). SOD and CAT activities in controls were found as 3.57 ± 0.84 U/mg protein and 2.19 ± 0.20 U/mg protein, respectively. In patients with malignancy, the SOD activity was 3.84 ± 0.73 U/mg protein while CAT activity was 1.03 ± 0.13 U/mg protein. Patients with benign breast disorders, SOD acti-vity was 4.09 ± 1.00 U/mg protein and CAT activity was 1.02 ± 0.18 U/mg protein. Whereas SOD activity did not differ between the groups of patients and controls, the mean catalase level in the control group was higher than in the benign and malign tumor groups (both p <0.001). Urinary neopterin concentration seems to be an important and useful biomarker in diagnosis of breast tumors in clinical practice.
[show abstract][hide abstract] ABSTRACT: The aim of this study is to investigate the effects of carbon dioxide (CO2) pneumoperitoneum on tyrosine hydroxylase (TH) activity and total protein (TP) levels.
Forty male Sprague-Dawley rats were randomized into 10 groups, each consisting of 10 rats. Groups 1 and 2 consisted of anesthesia and sham-operated control rats, respectively. In the study groups, 10 mm Hg (group 3) and 15 mm Hg (group 4) pneumoperitoneum with CO2 were accomplished. At the end of the procedures, the brains and adrenals were removed quickly, and the hypothalamus and adrenal medulla separated, weighed, and homogenized. TH activity and TP levels were determined.
The adrenal medulla TP and TH activity levels were decreased consistently and this decrease was significant in the sham and pneumoperitoneum groups compared with the control group (P<0.05). The adrenal medulla TP and TH activity levels were reduced significantly in group 4, as compared with the other groups (P<0.05). Elevation of hypothalamic TH activity in group 4 was significantly higher than in the other groups (P<0.05).
These results indicate that CO2 pneumoperitoneum applied with 10 and 15 mm Hg pressure gradually decreases the adrenal medulla TH activity; TH is an indispensable enzyme for the biosynthesis of catecholamines. CO2 pneumoperitoneum with 15 mm Hg pressure significantly elevated hypothalamus TH activity.
[show abstract][hide abstract] ABSTRACT: The aim of this study was to determine number and diameter of milk ducts in the nipple and to investigate the possible influences of age, breast weight, and diameter of the nipple on the number of ducts. Two hundred and twenty-six carcinoma mastectomy specimens were weighed and the nipple diameters measured. The number of ducts was counted in histological cross sections. Mean diameter of the nipple and mean breast weight were 13.9 mm and 844.6 g, respectively. There was a small but statistically significant positive correlation between nipple diameter and number of milk ducts (rho = 0.158; p = 0.01), but no correlation with breast weight. The mean number of ducts in the nipple duct bundle was 17.5. This is significantly higher than the number of ducts reported to open on the nipple surface. This discrepancy could reflect duct branching within the nipple or the presence of some ducts which do not reach the nipple surface. Smaller breast ducts (diameter < 0.5 mm) represent nearly 50% of the nipple ducts and could be a challenge to the ductoscopy technology.
European Surgical Research 02/2006; 38(6):545-9. · 0.75 Impact Factor
[show abstract][hide abstract] ABSTRACT: Thyroid malignancies can present in different manners, among them as asymptomatic solid nodule being the most puzzling. Nodules have been found in the 60-70 % of autopsy specimens and it is very important to rule out the malignancies in such cases. Incidence of carcinomatous changes is reported in 5-15 % of solitary nodules. We present the results of prospective study on 418 thyroidectomies with the aim to review the experience of our unit, to establish the correlation between clinical presentation and histopathology, to discuss the malignancy rates and surgical complications.
Five hundred eighteen consecutive cases of thyroidectomy 419 female (80.8 %), and 99 male (19.2 %) patients performed between January 2002 and October 2004 were included in this prospective study.
In 71 (13.7 %) cases the malignancy was found by paraffin specimens, the highest prevalence of malignancy being found in patients with nodular goiter (NG-18 %) followed by 14.6 % in multinodular goiter (MNG). The sensitivity of preoperative fine needle cytology (FNAC) was 83.3 % with false positive rate of 1.3 %. Complications were seen in 5.2 % of cases of which 4 (0.7 %) had hypoparathyroidism and 7 (1.3 %) had recurrent laryngeal nerve injury. All patients observed came from endemic area. Family history nearly doubles the risk of malignancy.
In an endemic area the nodular goiter is the most common. Preoperative cytology, although sensitive, gives a considerable number of false positive results. Results of thyroid surgery at a high volume centre are satisfactory with very low rates of recurrent laryngeal nerve and parathyroid injury. Probability of malignant transformation in a long standing thyroid swelling should always be kept in mind. There appears to be an increase in prevalence of thyroid malignancies in Turkey after Chernobyl disaster.
[show abstract][hide abstract] ABSTRACT: Detection of a breast mass accompanied by a contralateral axillary lymphadenopathy presents a dilemma because of the possible presence of an occult breast cancer on the same side as the axillary lymphadenopathy. A patient presented with an axillary lymphadenopathy from an occult breast cancer and a synchronous contralateral breast cancer, for which the differential diagnosis was established through a significant difference in estrogen and progesterone receptor levels. The patient was treated with neoadjuvant chemotherapy followed by bilateral modified radical mastectomy, adjuvant chemotherapy, and adjuvant radiation therapy. She is alive and free of disease 1.5 years after the diagnosis.
The Breast 05/2005; 14(2):157-62. · 2.49 Impact Factor
[show abstract][hide abstract] ABSTRACT: To compare the diagnosis of thyroid pathological findings by using frozen section and preoperative imprint.
From January 1998 to December 1999, one hundred and three consecutive patients admitted to Department of Surgery, Gazi University Medical Faculty for thyroid operation, were prospectively included into the study. In all patients, imprint and frozen section were carried out from their suspected nodules and the results were compared with the permanent biopsy. Those findings used to find out sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of frozen section and imprint. Because of the definitive differentiation of malignant or benign lesions could not be done, three patient were excluded from the study.
In our study; sensitivity, specificity, PPV, NPV and accuracy for imprints was found as 83.3%, 97.7%, 83.3%, 97.7% and 96% (respectively), while respective corresponding data for frozen section were 81.8%, 96.6%, 75%, 97.7% and 95%. In one patient, the pathological finding of follicular carcinoma as found by permanent section was accurately diagnosed by imprint, but missed by frozen section. Both the imprint and frozen section failed to diagnose two papillary carcinoma. Overall cancer rate among 103 patients was 12 % (nine papillary carcinoma, one Hürthle cell carcinoma and two follicular carcinoma).
Both the frozen sections and imprints showed high sensitivity rate and similar accuracy rates. So, if there is no opportunity for frozen section, the imprints could be used. Furthermore, the use of imprints is less time consuming and less expensive than that of frozen sections.
[show abstract][hide abstract] ABSTRACT: This study was conducted to examine the effects of peptidoleukotrienes on the ileal contractility disturbances induced by Serratia marcescens endotoxin in rats. Thirty-two male Wistar rats were divided into four groups (n = 8 each). The first group was given only an anesthetic agent (control group); the second group was given the endotoxin (endotoxin group); the third group was given a lipoxygenase inhibitor, nordihydroguaretic acid (NDGA); and the fourth group was given NDGA 10 min before administration of the endotoxin (NDGA+endotoxin group). The isolated ileum response was recorded in each group. Normal contractile activity was seen in the control group. After the endotoxin was given. the isolated ileum did not respond to 497acetylcholine (ACh) in the endotoxin group, but the contractile results of isolated ileum to ACh were similar to the control group results in both the NDGA and endotoxin+NDGA groups. The results of this study demostrate that leukotrienes may play a role in endotoxin-induced ileal contractility disturbances, and that the lipoxygenase inhibitor, NDGA, could be useful for the treatment of ileal motility disturbances induced by endotoxin.
Surgery Today 02/2001; 31(6):497-501. · 0.96 Impact Factor
[show abstract][hide abstract] ABSTRACT: Assessment of malignancy criteria in Huerthle cell neoplasm.
This study intends to review retrospectively the patients who were operated for Huerthle cell neoplasia at Gazi University, Department of General Surgery between January 1986 and October 1999. Pathological specimens from 63 patients (20 males and 43 females) were investigated in this study, 48 of which revealed Huerthle cell adenoma and 15 revealed Huerthle cell carcinoma. The mean age of the patients with Huerthle cell adenoma was 40.7+/-1.59 yr while it was 51.3+/-1.83 yr in patients with Huerthle cell carcinoma. Mann-Whitney U and Chi-square tests were used for statistical analysis.
. Fifty-two of the 63 patients had fine needle aspiration (FNA) biopsy prior to operation, 49 of those were reported to have suspected Huerthle cell neoplasia (HCN) and three had suspected Huerthle cell carcinoma (HCC). The sensitivity of FNA for HCN was 20 %, specificity was 100 %, positive predictive value was 100 % and negative predictive value was 76 %. For all patients, peroperative frozen section (FS) biopsy was examined. Fifty-nine of the FS specimens revealed HCN and four revealed HCC. The sensitivity, specificity, positive predictive value and negative predictive value of FS biopsy were 27 %, 79 %, 28.5 % and 77.5 %, respectively. In this retrospective study, there was a statistically significant correlation between malignancy and the size of the tumor (P<0.05) according to Chi-square test, and also a statistically significant correlation between malignancy and the age of the patient (P<0.05) according to Mann-Whitney U test.
In cases where FS and FNA biopsies cannot adequately define the benign or malignant behaviour of the tumor, the age of the patient and the diameter of the tumor must be taken into consideration for accurate surgical strategy. Particularly for 50 year-old and elderly, incidence of malignancy is statistically significant without considering sex of the patient.
[show abstract][hide abstract] ABSTRACT: The aims of this study were (1) to investigate the effect of experimental obstructive jaundice on the healing of intestinal anastomosis, and (2) to investigate the effect of pentoxifylline on the healing of intestinal anastomosis in rats with obstructive jaundice. Obstructive jaundice was induced in rats by the ligation and division of the common bile duct. Four days after this operation, either pentoxifylline or isotonic saline solution was administered intraperitoneally to these jaundiced rats and controls, and then intestinal anastomosis was performed. The concentrations of serum tumor necrosis factor alpha (TNF-alpha) and serum triglyceride of jaundiced and nonjaundiced rats were measured, and the quality of healing was evaluated by measuring the bursting pressure and hydroxyproline content of the anastomoses on the fifth and tenth days of anastomotic healing. Obstructive jaundice resulted in an impaired wound healing of the intestinal anastomosis in the rats. The administration of pentoxifylline to the jaundiced rats resulted in better anastomotic wound healing. The beneficial effects of pentoxifylline on anastomotic healing in rats with obstructive jaundice was attributed to its inhibitor effect on the endotoxin-induced TNF-alpha release from macrophages and monocytes, and the stabilizing effect on the neutrophils.
Surgery Today 02/2000; 30(10):896-902. · 0.96 Impact Factor
[show abstract][hide abstract] ABSTRACT: Glutamine (Gln), which is the most abundant free amino acid in the circulation, and also a primary fuel for rapidly dividing
cells, was used to determine its effects on incisional healing. The effect of Gln-enriched feeding was investigated using
tensile strength measurement, which reflects the quality and speed of regeneration, and by the measurement of tissue hydroxyproline
level which correlate directly with the collagen content of wounds. Forty albino Wistar rats in four equal groups received
a special diet 7 days prior to surgery and 7 days after surgery. On the 7th day of study a 5-cm dorsal midline skin incision
was made and then closed by interrupted sutures. Group 1 received a normal diet for all 14 days; group 2 received a Gln-enriched
diet 7 days prior to surgery and a normal diet 7 days after surgery; group 3 received a normal diet prior to surgery and a
Gln-enriched diet after surgery; group 4 received a constant Gln-enriched diet. On the 7th postoperative day, tensile strength
measurements and hydroxyproline level analyses were done. A preoperative Gln-enriched diet did not show any significant improvement
in the tensile strength and hydroxyproline levels on the 7th postoperative day, but a pre- and postoperative, and a postoperative
Gln-enriched diet significantly improved the tensile strength and hydroxyproline levels when compared with the normal diet
group (P<0.0001). These findings show that wound healing is better when Gln was added in the postoperative, or both pre- and postoperative
periods, but not when only added in the preoperative period.
European Journal of Plastic Surgery 01/2000; 23(2):78-81.
[show abstract][hide abstract] ABSTRACT: Breast cancer refractory to known effective agents is one of the major clinical problems frequently encountered in practice. Cisplatin and vinorelbine are known to be active drugs in anthracycline-refractory cases. In this phase II study, the effectiveness and tolerability of cisplatin and vinorelbine was investigated when used in combination as a salvage regimen in the treatment of metastatic refractory breast cancer.
Twenty-four patients with advanced refractory breast cancer who had been previously treated with a regimen containing doxorubicin were included in the study. Six of the 24 patients also received taxanes after failure of doxorubicin. Cisplatin at 80 mg/m2 on day 1 and vinorelbine at 25 mg/m2 on days 1 and 8 were given every 3 weeks.
A total of 98 cycles of chemotherapy was given, with a median of 4/patient. The response rate was 25% (2 [8.3%] complete and 4 [16.7%] partial responses). The median survival rates were 14 months in responders and 5.5 months in nonresponders (P = 0.0282). One complete and one partial response were observed in patients previously treated with paclitaxel (overall response rate, 33%). The median response duration was 12.5 mo (range, 4-21) in complete and 4.5 mo (range, 1.5-13) in the partial response group. Grade 3 and 4 neutropenia occurred in 9 patients, with no toxic deaths. Grade 2-3 nausea and vomiting in 6 patients and grade 1 neuropathy in 1 patient were noted.
Although the number of cases is insufficient to indicate that the combination will be effective, it is noteworthy in consideration of anthracycline and taxane refractory cases. A combination of cisplatin and vinorelbine seems to be a reasonable and acceptable choice as an alternative salvage regimen in such cases.
[show abstract][hide abstract] ABSTRACT: In a double blind prospective clinical study to evaluate the diagnostic potential of peroperative fine needle aspiration cytology as compared to peroperative frozen section in thyroid surgery.
The diagnostic value of one hundred consecutive preoperative (FNA) and peroperative fine needle aspiration (p-FNA), frozen section (FS) and permanent section (PS) examination for thyroid nodules were studied prospectively in order to assess and compare the accuracy, sensitivity and specificity.
Out of 100 patients PS showed 11 % of malignancies, while p-FNA showed 5 % and FS showed 6% of malignant cases with no false positive, but with 6 and 5 false negative results, respectively. Thus, as compared with FS, one false negative finding was obtained by p-FNA in a case of malignant tumor which could be definitely ascertained by frozen section technique. However, concerning the benign nodules no differences were found between p-FNA and FS.
Peroperative fine needle aspiration seems to be a useful method which can be properly performed because the nodule can be easily seen during the surgical procedure. However, further clinical observations of large numbers of patients are needed.
[show abstract][hide abstract] ABSTRACT: The aim of the present study was to investigate the effect of endothelin-1 on the isolated distal ileum and proximal colon in an experimentally induced ileus in rats. Ileal and colonic contractions by endothelin-1, acetylcholine alone and with endothelin-1 were recorded both in normal and experimentally induced paralytic ileus in rats. In the control group, all the responses to acetylcholine were found to be potentiated significantly when used together with endothelin-1 but in paralytic ileus group, no detectable change was observed in the responses of the amine after administration of acetylcholine together with endothelin-1. This study indicates that endothelin-1 might have an effect on gastrointestinal motility and postoperative paralytic ileus.
[show abstract][hide abstract] ABSTRACT: OBJECTIVE: In the retrospective study to review the records of patients who had undergone thyroid surgery between 1986-1995 and to determine the need of frozen section (FS) following FNA biopsy. METHODS: The records of 2083 patients who had thyroid surgery in Gazi University Medical Faculty Department of General Surgery between 1986-1995 were retrospectively reviewed to determine and compare the accuracy and significance of fine-needle aspiration (FNA) cytology and intraoperative frozen section (FS). Results. In 61 patients, both FNA and FS diagnosis were available for the comparison with the final pathologic diagnosis. In 196 patients, FNA diagnosis was available for the comparison with the final pathological diagnosis by permanent section and in 377 patients FS diagnosis was available for the comparison with the final pathological diagnosis. The sensitivity value for detection of malignancy by means of FNA was 57.1 % compared to 82.2 % by means of FS, and FS diagnosis was more specific (99 %) than FNA diagnosis (90.9 %). FNA diagnosis of benign conditions was correct in 141 of 150 (94 %) patients. FS diagnosis of benign conditions was correct in 313 of 321 (97.5 %) patients. Nine patients had the FNA findings that were positive for malignancy and FS confirmed this diagnosis in 8 patients. Conclusions. FNA is an important diagnostic tool for eliminating benign nodules, but it is not perfect. FS is very important for determining the surgical procedure, and because of direct observation of suspicious nodule, it is even more accurate. Using these tools together is more reliable, since the number of false positive and false negative values is lower than if only the individuals methods are used.