摘要
目的探讨术中冰冻切片(Frozen section,FS)与石蜡切片(Paraffin section,PS)病理检查在甲状腺乳头状增生与甲状腺乳头状癌(Papillary Thyroid Carcinoma,PTC)诊断中的价值。方法选择2022年1月—2023年10月本院收治的疑似甲状腺乳头状增生者51例、疑似PTC者61例作为研究对象,均给予术中冰冻切片检查,以石蜡切片病理检查结果为金标准,分析两种方案检出情况、诊断效能及不同疾病的免疫组化检查结果。结果以PS检查结果为金标准,术中FS检查对PTC检出率为97.22%、对甲状腺乳头状增生检出率为96.67%;以PS检查结果为金标准,术中FS检查对PTC诊断的准确率为95.08%、灵敏度为94.00%、特异度为96.00%;诊断甲状腺乳头状增生的准确率为94.12%、灵敏度为93.33%、特异度为95.24%,FS检查在甲状腺乳头状增生、甲状腺乳头状癌诊断中灵敏度、特异度、准确率对比无统计学意义(P>0.05);PTC患者CD56阳性检出率低于甲状腺乳头状增生,HBME-1、Galectin3阳性检出率与甲状腺乳头状增生对比,差异有统计学意义(P<0.05)。结论在甲状腺乳头状增生与PTC诊断中应用术中FS检查可行性较高,可方便医师在术中结合患者实际情况制定治疗方案,达到改善预后效果的目的,值得借鉴与学习,但结合实际情况发现该方案存在一定漏误诊,因此在临床诊断中需要加强各项检查工作,同时诊断中仔细辨别图像特点,尽可能地减少漏误诊率,为临床诊断甲状腺疾病提供参考。
Objective To explore the value of intraoperative frozen section(FS)and paraffin section(PS)pathological examination in the diagnosis of papillary thyroid hyperplasia and papillary thyroid carcinoma(PTC).Methods A study was conducted on 51 cases of suspected papillary thyroid hyperplasia patients and 61 cases of suspected PTC patients admitted to our hospital from January 2022 to October 2023.All cases underwent intraoperative frozen section examination,with the pathological examination results of paraffin sections serving as the gold standard.The detection status,diagnostic efficacy,and immunohistochemical examination results of different diseases were analyzed using the two methods.Results Using PS examination results as the gold standard,the detection rates of PTC and papillary thyroid hyperplasia in intraoperative FS examination were 97.22%and 96.67%,respectively.The accuracy,sensitivity,and specificity of intraoperative FS examination for the diagnosis of PTC were 95.08%,94.00%,and 96.00%,respectively;for diagnosing papillary thyroid hyperplasia,they were 94.12%,93.33%,and 95.24%,respectively.There was no statistically significant difference in sensitivity,specificity,and accuracy of FS examination in the diagnosis of papillary thyroid hyperplasia and PTC(P>0.05).The positive detection rate of CD56 in PTC patients was lower than that in papillary thyroid hyperplasia,and there were statistically significant differences in the positive detection rates of HBME-1,and Galectin3 compared to papillary thyroid hyperplasia(P<0.05).Conclusions The application of intraoperative FS examination in the diagnosis of papillary thyroid hyperplasia and PTC is highly feasible,which can facilitate physicians to develop treatment plans based on the actual situation of patients during surgery,and achieve the goal of improving prognosis.It is worth learning from.However,based on the actual situation,it has been found that this plan has certain omissions and misdiagnoses.Therefore,in clinical diagnosis,it is necessary to strengthen
作者
赖丽雅
廖志东
卢裕
郑渝兰
钟伟樑
Lai Liya;Liao Zhidong;Lu Yu;Zheng Yulan;Zhong Weiliang(Department of Pathology,Meizhou Hospital of Traditional Chinese Medicine,Meizhou,Guangdong 514000,China;Department of Oncology,Meizhou Hospital of Traditional Chinese Medicine,Meizhou,Guangdong 514000,China)
出处
《齐齐哈尔医学院学报》
2024年第22期2162-2166,共5页
Journal of Qiqihar Medical University
基金
2022年度梅州市社会发展科技计划项目(2022C0301060)。
关键词
甲状腺乳头状增生
甲状腺乳头状癌
术中冰冻切片
石蜡切片
病理诊断
Papillary thyroid hyperplasia
Papillary thyroid carcinoma
Intraoperative frozen sections
Paraffin sections
Pathologic diagnosis
