影响甲状腺肿瘤切除术中冷冻诊断准确率的相关因素分析  

Analysis of Factors Affecting the Accuracy of Frozen Diagnosis in Thyroid Tumor Resection

作　　者：李蕴霞 LI Yunxia(Department of Pathology,Yanling County People’s Hospital,Yanling,Henan 461200,China)

机构地区：[1]鄢陵县人民医院病理科,河南鄢陵461200

出　　处：《临床研究》2024年第4期133-136,共4页Clinical Research

摘　　要：目的探究影响甲状腺肿瘤切除术中冷冻诊断准确率的相关因素。方法选取2019年12月至2022年12月期间,鄢陵县人民医院收治的甲状腺肿瘤手术患者共计90例,全部研究对象均接受甲状腺肿瘤术中冷冻切片(FS)诊断以及术后常规病理学诊断。以术后常规病理学诊断结果为金标准,统计采用术中冷冻进行诊断一致性、延迟诊断情况,以及诊断灵敏度、特异度以及准确率;与此同时,对未能成功确诊的研究对象的相关因素进行分析研究,探讨造成甲状腺肿瘤切除术冷冻诊断偏差的相关因素。结果90例研究对象最终确诊为恶性甲状腺瘤患者共计51例。接受术中冷冻诊断结果中,假阴性6例,另外存在延迟诊断3例;术后常规病理学诊断延迟诊断2例。术中冷冻诊断同术后常规病理学诊断的准确度为90.00%[(42+39)/90];以术后常规病理诊断作为金标准,术中冷冻诊断的灵敏度为82.35%[42/(42+9)],特异度为100%[39/(39+0)];术中冷冻切片的取材不到位、冷冻温度不达标、受到取材区域限制、病理科医师的工作年限偏短是引起术中冷冻切片检查出现假阴性的独立危险因素。结论甲状腺肿瘤术中冷冻诊断技术同术后常规病理诊断存在较高的一致性,然而在诊断过程中仍有部分病例的诊断结果出现偏差,诊断过程需密切关注取材情况与客观条件的影响,方可获得更理想的诊断结果。Objective To explore the factors affecting the accuracy of frozen diagnosis in thyroid tumor resection.Methods A total of 90 patients with thyroid tumors who were treated in Yanling County People’s Hospital from December 2019 to December 2022 were selected.All the research subjects underwent frozen section(FS)diagnosis and routine pathological diagnosis after thyroid tumor surgery.With the results of routine pathological diagnosis after surgery as the gold standard,the consistency of diagnosis using intraoperative freezing,delayed diagnosis,and the sensitivity,specificity,and accuracy of diagnosis were statistically analyzed.At the same time,the related factors of the research objects that failed to be successfully diagnosed were analyzed to explore the related factors causing the deviation of frozen diagnosis in thyroid tumor resection.Results A total of 51 patients were finally diagnosed as malignant thyroid tumors among the 90 research subjects.In the results of intraoperative frozen diagnosis,there were 6 false negatives and 3 delayed diagnoses;there were 2 delayed diagnoses in routine pathological diagnosis after surgery.The accuracy of intraoperative frozen diagnosis and routine pathological diagnosis after surgery was 90.00%[(42+39)/90];with routine pathological diagnosis after surgery as the gold standard,the sensitivity of intraoperative frozen diagnosis was 82.35%[42/(42+9)],and the specificity was 100%[39/(39+0)];inadequate sampling of intraoperative frozen sections,substandard freezing temperature,restrictions on the sampling area,and short working years of pathologists are independent risk factors for false negatives in intraoperative frozen section examination.Conclusion The technology of intraoperative frozen diagnosis of thyroid tumors has a high consistency with routine pathological diagnosis after surgery,but there are still some cases where the diagnosis results are biased in the diagnosis process.The diagnosis process needs to pay close attention to the impact of sampling conditions and obje

关 键 词：甲状腺肿瘤切除术 冷冻诊断 术后病理诊断 相关性分析 

分 类 号：R736.1[医药卫生—肿瘤]