Accuracy rate of intraoperative frozen section in diagnosis of papillary thyroid microcarcinoma and its influencing factors
-
摘要: 目的 分析术中冰冻切片法诊断甲状腺微小乳头状癌的准确率及其影响因素。 方法 选取30例甲状腺微小乳头状癌患者,均接受手术治疗。手术过程中行冰冻切片病理检查,手术完成后行常规石蜡切片检查。将石蜡切片诊断结果作为疾病诊断"“金标准”,分析术中冰冻切片结果与金标准结果的相符性,探讨影响冰冻切片病理诊断准确性的相关因素。 结果 本组30例患者经术后石蜡切片诊断均确诊为甲状腺微小乳头状癌,确诊率为100.00%。冰冻切片病理诊断结果显示,有23例患者诊断为甲状腺微小乳头状癌,确诊率为76.67%; 3例患者因冰冻切片未切取到病变组织而漏诊,漏诊率为10.00%; 3例患者延迟诊断,延迟诊断率为10.00%; 1例患者误诊为桥本甲状腺炎和滤泡型腺瘤,误诊率为3.33%。影响冰冻切片准确性的单因素包括肿瘤直径、甲状腺钙化分型、包膜侵犯情况等(P<0.05或P<0.01); 多因素回归分析结果显示,包膜侵犯(浸润性生长)、肿瘤直径等均是影响冰冻切片病理诊断准确性的独立危险因素(P<0.01)。 结论 术中冰冻病理切片诊断法在甲状腺微小乳头状癌的诊断中具有较高准确性,但是也受到多种因素影响,应采取相关措施以避免给患者造成二次手术创伤。Abstract: Objective To analyze accuracy rate of intraoperative frozen section in diagnosis of papillary thyroid microcarcinoma and its influencing factors. Methods A total of 30 patients with papillary thyroid microcarcinoma were selected and treated with operation. The pathological examination of frozen section was performed during the operation, and the routine paraffin section was performed after the operation. The results of paraffin section were considered as the gold standard for disease diagnosis. The consistency between the results of intraoperative frozen section and gold standard was analyzed, and the relevant factors affecting the accuracy rate of pathological diagnosis of frozen section were explored. Results All the 30 patients were diagnosed as papillary thyroid microcarcinoma by paraffin section, and the diagnosis rate was 100.00%. The pathological diagnosis of frozen section showed that 23 patients were diagnosed as papillary thyroid microcarcinoma, with a diagnosis rate of 76.67%; 3 patients were missed because the frozen section was not cut with the pathological tissue, with a diagnosis rate of 10.00%; 3 patients were delayed in diagnosis, with a diagnosis rate of 10.00%; 1 patient was misdiagnosed as Hashimoto's thyroiditis and follicular adenoma, with a misdiagnosis rate of 3.33%. The single factors affecting the accuracy rate of pathological diagnosis of frozen section included tumor diameter, classification of thyroid calcification and condition of capsule invasion(P<0.05 or P<0.01). The results of multivariate regression analysis showed that capsule invasion(invasive growth)and tumor diameter were independent risk factors affecting the accuracy rate of pathological diagnosis of frozen section(P<0.01). Conclusion The method of intraoperative pathological frozen section has a high accuracy rate in the diagnosis of papillary thyroid microcarcinoma, - but it is also affected by many factors, so relevant measures should be taken to avoid secondary surgical trauma to patients.
-
-
邱娟. 甲状腺微小乳头状癌术中冰冻病理诊断研究及B-raf基因检测意义[J]. 实用癌症杂志, 2019, 34(5): 730-732 , 742.
刘茜. 对甲状腺微小乳头状癌患者的病灶组织冰冻切片进行术中病理检查的效果[J]. 当代医药论丛, 2019, 17(4): 99-100. Ito Y, Miyauchi A, Hirokawa M, et al. Prognostic value of the 8th edition of the tumor-node-metastasis classification for patients with papillary thyroid carcinoma: a single-institution study at a high-volume center in Japan[J]. Endocrine Journal, 2018, 33(9): 60-68.
王玉玲, 王春光, 栾艳艳, 等. 甲状腺微小乳头状癌常规超声、弹性成像表现及其与病理的对照研究[J]. 医学影像学杂志, 2018, 28(10): 1643-1646. 张科, 蔡勇, 刘志良. 甲状腺微小乳头状癌预后指标的研究[J]. 实用癌症杂志, 2017, 32(1): 169-170. Liao H, Khan A, Miron P M, et al. Mammary Analogue Secretary Carcinoma of the Thyroid Mimicking Locally Advanced Papillary Thyroid Carcinoma: A Rare Case Report[J]. International Journal of Surgical Pathology, 2017, 47(11): 459-463.
陆云云. 甲状腺微小乳头状癌患者术中的冰冻病理诊断结果调查研究[J]. 临床医药文献电子杂志, 2017, 19(47): 76-77 , 80.
Park J S, Chang J W, Liu L, et al. Clinical implications of microscopic extrathyroidal extension in patients with papillary thyroid carcinoma[J]. Oral Oncology, 2017, 33(10): 183-187.
臧雪丹, 王燕, 李艺等. 术前超声对甲状腺微小乳头状癌中央区淋巴结转移的诊断价值[J]. 中国超声医学杂志, 2016, 32(8): 680-683. 周春兰, 闻华, 贺燕美. 甲状腺微小乳头状癌超声诊断与病理特点的对比分析[J]. 药品评价, 2016, 30(b12): 149-150. Lang H H, Wong C K H. Lobectomy is a more Cost-Effective Option than Total Thyroidectomy for 1 to 4 cm Papillary Thyroid Carcinoma that do not Possess Clinically Recognizable High-Risk Features[J]. Annals of Surgical Oncology, 2016, 23(11): 1-12.
郭芳, 谭雨萌, 冯曦, 等. 甲状腺微小乳头状癌术中快速病理形态学特点及临床分析[J]. 肿瘤防治研究, 2016, 43(1): 67-71. 武元元, 王军, 管玲, 等. TI-RADS分级联合超声弹性成像诊断甲状腺微小乳头状癌价值研究[J]. 中国实用外科杂志, 2016, 36(5): 552-555. -
期刊类型引用(27)
1. 韩维静，赵伟涛，张帅通. 冰冻切片病理诊断在甲状腺微小乳头状癌术中应用体会. 延边大学医学学报. 2025(01): 52-54 . 
百度学术
2. 余萱玺，龙秀荣，张学平. 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. 生命科学仪器. 2024(01): 165-167 . 百度学术
3. 刘建，张立英，贾兴东，冯艳玉. 甲状腺癌冰冻切片病理不能明确诊断的临床因素分析. 中国现代医生. 2024(18): 38-42 . 百度学术
4. 李军，许研，卓倩. 甲状腺微小乳头状癌的术中冰冻病理诊断探讨. 系统医学. 2024(10): 46-48 . 百度学术
5. 毛左乾. 术中冰冻切片病理检查诊断甲状腺微小癌的价值分析. 中国社区医师. 2024(16): 86-88 . 百度学术
6. 齐彬，栗玉娇，周平安，张翔. 甲状腺微小乳头状癌术中冰冻切片病理诊断准确性分析. 系统医学. 2024(18): 167-169+198 . 百度学术
7. 莫林，韩泽贤，欧范妍，梁业志，韦康来. 术中快速冰冻病理切片检查在诊断甲状腺结节中的应用效果. 医药前沿. 2024(20): 47-49 . 百度学术
8. 赖丽雅，廖志东，卢裕，郑渝兰，钟伟樑. 甲状腺乳头状增生与甲状腺乳头状癌术中冰冻切片与石蜡切片病理诊断结果的对比分析. 齐齐哈尔医学院学报. 2024(22): 2162-2166 . 百度学术
9. 张檑，张玲，王义龙. 病理切片机在甲状腺癌手术患者病理检查中的应用及可信性分析研究. 现代仪器与医疗. 2023(01): 29-32 . 百度学术
10. 崔小光，陈昌伟. 冰冻切片对甲状腺微小乳头状癌术中病理诊断的准确性及价值. 中国卫生标准管理. 2023(04): 110-113 . 百度学术
11. 王惠国. 甲状腺微小乳头状癌诊断中术中冰冻病理的应用价值体会. 中国实用医药. 2023(09): 96-98 . 百度学术
12. 段鸿梅，蔡为民，盛仁明，周燕芳. 术中冰冻病理检查对甲状腺微小乳头状癌诊断的准确率分析. 系统医学. 2023(02): 46-49 . 百度学术
13. 罗燕. 冰冻病理技术在甲状腺乳头状癌诊断中的效果分析. 现代诊断与治疗. 2023(11): 1688-1690 . 百度学术
14. 杨晓波，李俊，张爱兵. 术中冰冻切片技术诊断甲状腺乳头状癌的价值. 系统医学. 2023(14): 171-173 . 百度学术
15. 许研. 甲状腺冰冻与石蜡切片的病理诊断价值观察. 中国医药指南. 2022(04): 74-76+80 . 百度学术
16. 刘军. 卵巢肿瘤术中冰冻切片的病理诊断分析及临床价值. 中国卫生标准管理. 2022(03): 183-186 . 百度学术
17. 孟峰芳. 甲状腺冰冻切片病理检查在鉴别其良恶性价值中的应用. 中国卫生标准管理. 2022(07): 73-75 . 百度学术
18. 王超柱，付冬妍. 冰冻切片对甲状腺微小癌术中病理诊断的准确性及漏诊率、误诊率分析. 中国医药科学. 2022(15): 182-185 . 百度学术
19. 李晓，曹卓，李明显，刘红英，黄镇栋，郑广娟，何青莲. 一种生物色标在冰余石蜡制片中的应用体会. 临床与实验病理学杂志. 2022(09): 1141-1142 . 百度学术
20. 李明显，周娜，郑细闰，杜晓华，李晓，郑广娟，何青莲，汤丽鹏. 一种红色标签纸在甲状腺小病灶冰冻切片过程中的应用体会. 中国临床解剖学杂志. 2022(06): 748-750 . 百度学术
21. 李轩飞，张静文. 术中冰冻切片与术后石蜡切片对PTMC病理诊断的效果分析. 菏泽医学专科学校学报. 2022(04): 26-29+33 . 百度学术
22. 徐鹏育. 术中冰冻切片病理诊断甲状腺微小乳头状癌的价值. 临床医学研究与实践. 2022(30): 107-109 . 百度学术
23. 陈海敏，江沂，刘婉，江桂英. 甲状腺良恶性鉴别中应用冰冻切片及石蜡切片病理检查的价值. 人人健康. 2021(08): 66-67 . 百度学术
24. 成瑶. 术中快速冰冻切片在甲状腺乳头状癌诊断中的应用分析. 临床医学工程. 2021(05): 651-652 . 百度学术
25. 杨丽英，闵文，朱杰，谭永兴. 甲状腺微小乳头状癌术中冰冻切片病理诊断的准确性及相关影响因素. 临床医学研究与实践. 2021(31): 36-38 . 百度学术
26. 张宏岩. 术中冰冻切片病理诊断在甲状腺微小乳头状癌中的应用价值. 中国实用医药. 2021(31): 202-204 . 百度学术
27. 刘爽，宋秀平，周宝华. 甲状腺冰冻切片与石蜡切片的病理诊断价值比较. 当代医学. 2021(34): 143-144 . 百度学术
其他类型引用(0)
计量
- 文章访问数: 547
- HTML全文浏览量: 101
- PDF下载量: 14
- 被引次数: 27
下载:
苏公网安备 32100302010246号