术中快速冰冻与细针穿刺活检在甲状腺微小癌诊断中的研究价值  

Research Value of Rapid Freezing and Fine Needle Aspiration Biopsy in the Diagnosis of Thyroid Microcarcinoma

作　　者：郭瑞娜[1] 杨会杰[1] 魏民[1] 李修顺[1] 张莹丽 王英 Guo Ruina;Yang Huijie;Wei Min;Li Xiushun;Zhang Yingli;Wang Ying(Department of Pathology,Puyang Oilfield General Hospital,Puyang 457001,China)

机构地区：[1]濮阳市油田总医院病理科,河南濮阳457001

出　　处：《哈尔滨医药》2021年第1期25-27,共3页Harbin Medical Journal

摘　　要：目的观察术中快速冰冻与细针穿刺活检(FNA)在甲状腺微小乳头状癌(PTMC)诊断中的研究价值。方法对440例甲状腺微小肿瘤(TMA)患者临床资料进行回顾性分析,以术后组织石蜡切片病理学检查结果为“金标准”,比较术中冰冻切片(FS)与FNA鉴别诊断TMA良恶性的准确性差异。结果术中FS诊断PTMC的灵敏度为97.23%,特异度为87.83%,阳性预测值为95.76%,阴性预测值为91.82%,准确度为94.77%,Kappa值为0.863。FNA诊断PTMC的灵敏度为91.38%,特异度为86.96%,阳性预测值为95.19%,阴性预测值为78.12%,准确度为90.23%,Kappa值为0.756,准确度明显低于术中FS(χ^(2)=6.552,P=0.010)。结论术中FS相较于FNA能提供更为全面的TMA诊断信息,对PTMC确诊具有重要意义。Objective To observe the research value of rapid freezing and fine needle aspiration biopsy(FNA)in the diagnosis of thyroid micropapillary carcinoma.Methods The clinical data of 440 patients with minimal thyroid tumor(TMA)were retrospectively analyzed.The pathological examination results of paraffin sections of postoperative tissues were the"gold standard".The accuracy of FS and FNA in the differential diagnosis of benign and malignant TMA was compared.Results The sensitivity of FS in diagnosis of PTMC was 97.23%(316/325),the specificity was 87.83%(101/115),the positive predictive value was 95.76%(316/330),and the negative predictive value was 91.82%(101/110),with an accuracy of 94.77%(417/440)and a Kappa value of 0.863.The sensitivity of FNA in diagnosis of PTMC was91.38%(297/325),the specificity was86.96%(100/115),positive predictive value was 95.19%(297/312),negative predictive value was 78.12%(100/128),accuracy was 90.23%(397/440),and Kappa value was 0.756,The accuracy is significantly lower than the intraoperative FS(χ^(2)=6.552,P=0.010).Conclusions Compared with FNA,intraoperative FS can provide more comprehensive TMA diagnostic information,which is of great significance for the diagnosis of PTMC.

关 键 词：甲状腺微小癌 术中快速冰冻 细针穿刺活检 术后组织石蜡切片 

分 类 号：R736.1[医药卫生—肿瘤]