冰冻切片病理检查对良恶性甲状腺肿瘤的鉴别诊断价值  

Value of frozen section pathological examination in differential diagnosis of benign and malignant thyroid tumor

作　　者：雷先华 王冬梅 廖伟莲 谢鋆辉 LEI Xianhua;WANG Dongmei;LIAO Weilian;XIE Junhui(Department of Pathology,Ganzhou Cancer Hospital,Ganzhou 341000,Jiangxi,China)

机构地区：[1]赣州市肿瘤医院病理科,江西赣州341000

出　　处：《癌症进展》2025年第5期548-551,567,共5页Oncology Progress

基　　金：江西省卫生健康委科技计划项目(20231019)。

摘　　要：目的探讨冰冻切片病理检查对良恶性甲状腺肿瘤的鉴别诊断价值。方法选取100例甲状腺肿瘤患者作为研究对象。所有患者均接受肿瘤切除术治疗,进行术中冰冻切片及石蜡切片病理检查,石蜡切片病理检查示甲状腺恶性肿瘤80例,甲状腺良性肿瘤20例。结果冰冻切片诊断甲状腺癌的准确度为96.00%(96/100),特异度为95.00%(19/20),灵敏度为96.25%(77/80),阳性预测值为98.72%(77/78),阴性预测值为86.36%(19/22),一致性较好(Kappa=0.880)。冰冻切片与石蜡切片诊断甲状腺乳头状癌、甲状腺滤泡癌、甲状腺髓样癌的一致性均较高(Kappa=0.792、0.688、1.000),冰冻切片与石蜡切片诊断甲状腺未分化癌的一致性中等(Kappa=0.500)。结论冰冻切片诊断良恶性甲状腺肿瘤的准确度、特异度、灵敏度均较高,诊断符合率高,能够较好地鉴别甲状腺肿瘤的病变性质、病理类型及肿瘤分级。Objective To explore the value of frozen section pathological examination in differentiating diagnosis of benign and malignant thyroid tumors.Method A total of 100 patients with thyroid tumor were selected as the research object.All patients received tumor resection,intraoperative frozen section and paraffin section pathological examination,paraffin section pathological examination showed 80 cases of malignant thyroid tumors and 20 cases of benign thyroid tumors.Result The accuracy,specificity,sensitivity,positive predictive value and negative predictive value of frozen section in the diagnosis of thyroid tumor were 96.00%(96/100),95.00%(19/20),96.25%(77/80),98.72%(77/78)and 86.36%(19/22),respectively.The consistency was good(Kappa=0.880).The consistency of frozen section and paraffin section in the diagnosis of papillary thyroid carcinoma,follicular thyroid carcinoma and medullary thyroid carcinoma were high(Kappa=0.792,0.688,1.000),and the consistency of frozen section and paraffin section in the diagnosis of anaplastic thyroid carcinoma was moderate(Kappa=0.500).Conclusion The accuracy,specificity and sensitivity of frozen section in the diagnosis of benign and malignant thyroid tumors are high,and the diagnostic coincidence rate is high.Frozen section can better identify the lesion nature,pathological type and tumor grade of thyroid tumors.

关 键 词：甲状腺结节 冰冻切片 石蜡切片 甲状腺癌 诊断价值 

分 类 号：R736.1[医药卫生—肿瘤]