甲状腺乳头状癌的术中冰冻病理及应用意义探析(1)
DOI：10.16662/j.cnki.1674-0742.2017.16.037
[摘要] 目的 研究探讨术中冰冻病理甲状腺乳头状癌诊断中的应用意义。方法 整群选取2015年1月—2017年3月收治的93例经术后石蜡切片检查或免疫组化检查确诊为甲状腺乳头状癌的患者作为研究对象，术前切去病变组织进行冰冻切片病理检查，在光镜下观察其病变特点，并以术后石蜡切片病理诊断结果为依据，计算其诊断的准确率。 结果 该文送检的93例术中冰冻切片检查标本中，91例与术后石蜡切片诊断结果完全符合，确诊率为97.8%，其中，病灶直径在1 cm以下的甲狀腺乳头状微小癌34例，乳头状癌滤泡亚型1例，甲状腺滤泡癌4例，低分化癌2例，弥漫大B细胞性淋巴瘤1例，经典型甲状腺乳头状癌51例，其各自的确诊率分别为97.1%、100.0%、75.0%、100.0%、100.0%、100.0%；3例延期诊断，1例为假阴性。结论 通过术中冰冻病理可以对甲状腺乳头状癌进行快速诊断，且有较高的诊断准确率，但要注意规范术中病理组织的取材方法，提高对滤泡亚型、包裹型乳头状癌形态学特征的认知与熟悉程度，提高诊断准确率，为患者的治疗提供可靠信息。
[关键词] 甲状腺乳头状癌；术中冰冻病理；诊断
[中图分类号] R736 [文献标识码] A [文章编号] 1674-0742(2017)06(a)-0037-03
Study on Intraoperative Frozen Pathology and Application Significance of Thyroid Papillary Carcinoma
ZHANG Dong-ying
Department of Pathology， Pizhou People’s Hospital， Pizhou， Jiangsu Province， 221300 China
[Abstract] Objective To research the intraoperative frozen pathology and application significance of thyroid papillary carcinoma. Methods 93 cases of patients with thyroid papillary carcinoma admitted and treated in our hospital from January 2015 to March 2017 were selected and the lesion tissues were resected and were given the frozen pathology examination， and the lesion features were observed and the accurate rate of diagnosis was calculated according to the pathological diagnosis results of paraffin sections after surgery. Results Of 93 intraoperative frozen sections examination specimens， the results of 91 cases were totally consistent with the postoperative paraffin sections diagnosis results， and the confirmation rate was 97.8%， and there were 34PTMC cases whose lesion diameter was below 1 cm， 1 case with papillocarcinoma subtype， 4 cases with thyroid follcular carcinoma， 2 cases with poorly differentiated carcinoma， 1 case with diffuse large b cell lymphoma， 51 cases with papillary thyroid carcinoma， and the confirmation rate of them was respectively 97.1%，100.0%，75.0%，100.0%，100.0%，100.0%， and 3 cases were delayed diagnosis and 1 case was with false negative. Conclusion The accurate rate of intraoperative frozen pathology in rapid diagnosis of thyroid papillary carcinoma is higher， and we should pay attention to standardizing the material drawing method of the intraoperative pathological tissues and improve the awareness and mastery of morphological characteristics of follicular subtypes and papillary papillary carcinoma and improve the diagnosis accurate rate thus providing reliable information of treatment of patients., 百拇医药(张东英)
[摘要] 目的 研究探讨术中冰冻病理甲状腺乳头状癌诊断中的应用意义。方法 整群选取2015年1月—2017年3月收治的93例经术后石蜡切片检查或免疫组化检查确诊为甲状腺乳头状癌的患者作为研究对象，术前切去病变组织进行冰冻切片病理检查，在光镜下观察其病变特点，并以术后石蜡切片病理诊断结果为依据，计算其诊断的准确率。 结果 该文送检的93例术中冰冻切片检查标本中，91例与术后石蜡切片诊断结果完全符合，确诊率为97.8%，其中，病灶直径在1 cm以下的甲狀腺乳头状微小癌34例，乳头状癌滤泡亚型1例，甲状腺滤泡癌4例，低分化癌2例，弥漫大B细胞性淋巴瘤1例，经典型甲状腺乳头状癌51例，其各自的确诊率分别为97.1%、100.0%、75.0%、100.0%、100.0%、100.0%；3例延期诊断，1例为假阴性。结论 通过术中冰冻病理可以对甲状腺乳头状癌进行快速诊断，且有较高的诊断准确率，但要注意规范术中病理组织的取材方法，提高对滤泡亚型、包裹型乳头状癌形态学特征的认知与熟悉程度，提高诊断准确率，为患者的治疗提供可靠信息。
[关键词] 甲状腺乳头状癌；术中冰冻病理；诊断
[中图分类号] R736 [文献标识码] A [文章编号] 1674-0742(2017)06(a)-0037-03
Study on Intraoperative Frozen Pathology and Application Significance of Thyroid Papillary Carcinoma
ZHANG Dong-ying
Department of Pathology， Pizhou People’s Hospital， Pizhou， Jiangsu Province， 221300 China
[Abstract] Objective To research the intraoperative frozen pathology and application significance of thyroid papillary carcinoma. Methods 93 cases of patients with thyroid papillary carcinoma admitted and treated in our hospital from January 2015 to March 2017 were selected and the lesion tissues were resected and were given the frozen pathology examination， and the lesion features were observed and the accurate rate of diagnosis was calculated according to the pathological diagnosis results of paraffin sections after surgery. Results Of 93 intraoperative frozen sections examination specimens， the results of 91 cases were totally consistent with the postoperative paraffin sections diagnosis results， and the confirmation rate was 97.8%， and there were 34PTMC cases whose lesion diameter was below 1 cm， 1 case with papillocarcinoma subtype， 4 cases with thyroid follcular carcinoma， 2 cases with poorly differentiated carcinoma， 1 case with diffuse large b cell lymphoma， 51 cases with papillary thyroid carcinoma， and the confirmation rate of them was respectively 97.1%，100.0%，75.0%，100.0%，100.0%，100.0%， and 3 cases were delayed diagnosis and 1 case was with false negative. Conclusion The accurate rate of intraoperative frozen pathology in rapid diagnosis of thyroid papillary carcinoma is higher， and we should pay attention to standardizing the material drawing method of the intraoperative pathological tissues and improve the awareness and mastery of morphological characteristics of follicular subtypes and papillary papillary carcinoma and improve the diagnosis accurate rate thus providing reliable information of treatment of patients., 百拇医药(张东英)