术中冰冻切片检查用于甲状腺微小乳头状癌诊断中的准确性分析  

Accuracy Analysis of Intraoperative Frozen Section in the Diagnosis of Thyroid Micropapillary Carcinoma

作　　者：余萱玺 龙秀荣 张学平 Yu Xuan Xi;Long Xiurong;Zhang Xueping(Department of Pathology,Liuhe District People's Hospital,Nanjing Jiangsu 211500,China)

机构地区：[1]南京市六合区人民医院病理科,江苏南京211500

出　　处：《生命科学仪器》2024年第1期165-167,共3页Life Science Instruments

摘　　要：目的 探讨分析术中冰冻切片检查在甲状腺微小乳头状癌诊断中的准确性。方法 选择医院2018年1月至2023年12月收治的51例疑似甲状腺微小乳头状癌患者,均于术中采集组织进行冰冻切片检查,并在术后进行石蜡切片对照。根据石蜡切片结果,评估术中冰冻切片对诊断甲状腺微小乳头状癌的效能,同时分析术中冰冻切片的镜下特征。结果 术后石蜡切片病理诊断显示,阳性40例,阴性11例;术中冰冻切片检查诊断显示,阳性39例,阴性12例。以术后石蜡切片病理诊断结果为金标准,该方法诊断准确度98.04%(50/51)、灵敏度97.50%(39/40)、特异度100.00%(11/11)、阳性预测值100.00%(39/39)、阴性预测值91.67%(11/12),与石蜡切片诊断结果的一致性较好(Kappa=0.94)。术中冰冻切片检查显示,核增大/卵圆核、肿瘤纤维环、周围组织浸润特征检出率均超过90%,毛玻璃核、假包涵体/核构检出率均低于20%。结论 术中冰冻切片检查对甲状腺微小乳头状癌的诊断效能高,但需注意对镜下特征的观察,以避免漏诊。Objective:To investigate and analyze the accuracy of intraoperative frozen section examination in the diagnosis of papillary thyroid carcinoma.Methods:From January 2018 to December 2023,51 patients with suspected papillary thyroid carcinoma were selected. All the tissues were collected for frozen section examination during operation, and paraffin sections were compared after operation. According to the results of paraffin section, the efficacy of intraoperative frozen section in the diagnosis of papillary thyroid carcinoma was evaluated, and the microscopic characteristics of intraoperative frozen section were analyzed.Results:The pathological diagnosis of paraffin section after operation showed that 40 cases were positive and 11 cases were negative. The diagnosis of intraoperative frozen section showed that 39 cases were positive and 12 cases were negative. Taking the pathological diagnosis results of paraffin sections after operation as the gold standard, the diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of this method were 98.04%(50/51),97.50%(39/40),100.00%(11/11),100.00%(39/39) and 91.67%(91.67%,respectively). Intraoperative frozen section examination showed that the infiltration characteristics of nucleus enlargement/oval nucleus, tumor fibrous ring and surrounding tissues all accounted for more than 90%, and the proportion of ground glass nucleus and false inclusion/nuclear structure was less than 20%.Conclusion:intraoperative frozen section examination is highly effective in the diagnosis of papillary thyroid carcinoma, but attention should be paid to the observation of microscopic features to avoid missed diagnosis.

关 键 词：甲状腺微小乳头状癌 冰冻切片 石蜡切片 诊断效能 镜下特征 

分 类 号：R736.1[医药卫生—肿瘤]