术中冷冻切片未能确诊的甲状腺癌:对策及疗效分析  

Unconfirmed thyroid cancer of intraoperative frozen-section pathology:strategy and analysis of curative effect

作　　者：胡作军[1] 王深明[1] 王燕华[1] 李松奇[1] 陈国锐[1] 

机构地区：[1]中山医科大学附属第一医院外科,广东广州510080

出　　处：《中国普通外科杂志》2002年第5期267-269,共3页China Journal of General Surgery

摘　　要：目的　探讨临床疑诊但术中冷冻切片未能确诊的甲状腺癌 (甲癌 )的处理对策及疗效。方法　回顾性分析 1980年 1月～ 1999年 12月收治的临床疑诊但术中冷冻切片未能确诊的甲癌 2 9例的临床资料。结果　临床高度疑诊为甲癌的 31例中有 2 9例冷冻切片未能确诊 ,而由术后石蜡切片证实为癌。一期手术行甲状腺患叶全切除 2 0例 ,二期根治手术 11例。随访期间无 1例复发癌或转移。一期手术与二期手术的并发症发生率有显著性差异 ( P <0 .0 5 )。结论　冷冻切片诊断甲癌有一定的假阴性率。对于临床高度怀疑甲癌而冷冻切片未能确诊的病例一期行患叶甲状腺全切除术是可行的 ,可避免二期手术的并发症。掌握大体病理标本的特点有助于术式选择。Objective To study the management and curative effect of the thyroid cancer suspected clinically but with inconclusive frozen-section intraoperatively. Methods The clinical data of 29 consecutive cases of thyroid cancer suspected clinically but with inconclusive frozen-section intraoperatively admitted to our hospital during Jan 1980 to Dec 1999 were analyzed retrospectively. Results Among these 31 suspected patients 29 were negative on frozen-section but confirmed thyroid cancer on postoperative paraffin-section. 20 underwent total involved lobe thyroidectomy in one-stage and other 11 as a second stage. No case recurred or metastased in the follow-up. Complication incidence was significantly different between one-stage and two-stage procedure (P < 0.05). Conclusions Frozen-section diagnosing thyroid cancer has specific false negative. Performing total involved lobe thyroidectomy in one-stage without any complication of two-stage procedure is feasible to those suspected patients. Mastering the pathological features of block specimens contributes to the choice of operative pattern.

关 键 词：甲状腺癌 对策 疗效 甲状腺肿瘤 冷冻切片 病理诊断 

分 类 号：R736.1[医药卫生—肿瘤]