冷冻切片联合细胞印片在甲状腺疾病术中快速病理诊断中的应用价值  

Value of frozen section combined with cytological imprint in rapid pathological diagnosis of thyroid diseases

作　　者：朱皓皞 温剑峰[1] 任光玉 张友梁 ZHU Hao-hao;WEN Jian-feng;REN Guang-yu;ZHANG You-liang(Department of Pathology,908 Hospital of PLA Joint Logistic Support Force,Nanchang 330002,China)

机构地区：[1]中国人民解放军联勤保障部队第九○八医院病理科,南昌330002

出　　处：《诊断病理学杂志》2023年第6期525-528,536,共5页Chinese Journal of Diagnostic Pathology

基　　金：中国人民解放军联勤保障部队第九〇八医院苗子培育基金(项目编号:2019NC0009)。

摘　　要：目的探讨冷冻切片联合细胞印片在甲状腺疾病术中快速病理诊断中的应用价值。方法收集2020-01—2022-06收治的行甲状腺术中冷冻病理检查289例患者的临床资料,对术中送检标本分别行细胞学印片及冷冻切片快速病理检查,以术后石蜡切片病理诊断结果为“金标准”,分析单独细胞印片、单独冷冻切片所用时间及两者单独和联合检测的敏感性、特异性、诊断准确率,并分析影响其诊断准确性的相关因素。结果本组包括甲状腺良性疾病170例,甲状腺癌119例,诊断时效细胞印片明显短于冷冻切片,差异有统计学意义(P<0.05)。单独细胞印片诊断的敏感性、特异性和诊断准确率分别为95%、98.8%和97.2%;单独冷冻切片诊断的敏感性、特异性和诊断准确率分别为98.3%、100%和99.3%;结合大体标本观察及两者联合诊断甲状腺癌的敏感性为99.2%,特异性为100%,诊断符合率为99.7%。结论冷冻切片联合细胞印片能提高甲状腺术中快速病理诊断的敏感性、特异性及准确率,细胞印片具有重要的补充作用,联合检测具有临床应用价值。Objective To explore the value of frozen section combined with cytology imprint in rapid pathological diagnosis of thyroid diseases.Methods The clinical data of 289 patients who underwent intraoperative frozen pathological examination of thyroid gland from January 2020 to June 2022 were collected.The tissue samples sent for examination during the operation were subject to cytological imprinting and frozen section rapid pathological examination respectively.Taking the pathological diagnosis results of paraffin section as the“gold standard”,the time taken for simple cytological imprinting and simple frozen section examination was analyzed,as well as the sensitivity,specificity and diagnostic accuracy rate,and explored the related factors that affected its diagnostic accuracy rate.Results The data of this group included 170 cases of benign thyroid diseases and 119 cases of thyroid cancer.The time used for cytology imprint was significantly less than the time for frozen section(P<0.05).The sensitivity,specificity and diagnostic accuracy of cytology imprint alone were 95%,98.8% and 97.2% respectively;the sensitivity,specificity and diagnostic accuracy of frozen sections alone were 98.3%,100% and 99.3%,respectively.Combined with gross specimen and the both techniques in the diagnosis of thyroid cancer,the sensitivity was 99.2%,the specificity was 100%,and the diagnostic coincidence rate was 99.7%.Conclusion Frozen section combined with cytology imprint can improve the sensitivity,specificity and accuracy of intraoperative rapid pathological diagnosis for thyroid diseases.Cytology imprint has an important complementary role,and joint detection has clinical application value.

关 键 词：冷冻切片 细胞印片 甲状腺 病理诊断 

分 类 号：R736.1[医药卫生—肿瘤]