465例甲状腺肿物术中冰冻切片诊断研究.docVIP

465例甲状腺肿物术中冰冻切片诊断研究[摘要] 目的 探讨冰冻切片在甲状腺手术中的临床应用,提高甲状腺肿物冰冻切片诊断的准确率。方法 回顾性对比观察465例甲状腺肿物冰冻切片和石蜡切片。结果 冰冻切片诊断良性病变437例,恶性肿瘤21例,延迟7例;石蜡切片对照良性病变433例,恶性肿瘤32例,其中冰冻切片假阴性诊断5例,假阳性诊断1例,冰冻切片确诊率为97.2%。结论 冰冻切片对甲状腺肿物术中定性及术式选择具有重要参考价值。正确的取材方法,提高对甲状腺良恶性肿瘤的判别能力,可提高甲状腺术中诊断准确率。 [关键词] 诊断; 冰冻切片; 石蜡切片; 甲状腺肿瘤 [中图分类号] R446.8 [文献标识码] A [文章编号] 1673-9701(2009)23-116-02 Freezing Slice Diagnosis on Thyroid Neoplasms:an Analysis of 465 Cases WU Youming WANG Hongxia GUO Zhouqing HUANG Dong MAI Baihua Department of Pathology,Xiaolan Hospital of Southern Medical University,Zhongshan 528415,China [Abstract] ObjectiveTo discuss the clinical application of frozen section in thyroid operation so as to raise the rate of correct diagnosis . MethodsA retrospective review was made to 465 frozen sections and paraffin sections. ResultsThe frozen section diagnosis showed that 437 cases with benign lesion,21 cases with m alignant tumor and there were 7 delayed diagnosis;in the control,the paraffin section showed 433 cases with benign lesion and 32 cases with m alignant tumor;There were 5 false-negative diagnosis and 1 false-positive diagnosis by frozen section and conformed diagnosis rate of frozen section reached 97.2%. ConclusionFrozen section is valuable in the diagnosis of thyroid neoplasms and important for the choice of opration method. The correct diagnosing rate of frozen section in thyroid operation may be raised by to improve the pathological diagnoses of thyroid tumor and improving the method. [Key Words]Diagnosis; Frozen section; Paraffin section; Thyroid tumor 甲状腺术中冰冻是病理科最常见的工作任务之一,因其病变的复杂性,故也是最容易出错的地方之一。因为冰冻的结果直接关系到病人的手术方式,故术中对甲状腺肿物良恶性的判断显得尤其重要,如何更准确地进行术中病理诊断,是病理工作者追求的目标,我们总结了本院465例术中冰冻切片并与常规进行对比分析,结合文献探讨一下如何提高甲状腺术中诊断的准确性。 1 材料与方法 1.1 一般材料 2005年1月～2009年4月本院病理科所做的冰冻切片465例,其中男性69例,女性396例,年龄最大者83岁,最小13岁,平均年龄为41岁;32例恶性者年龄为13～66岁,其中女性30例,男性2例。 1.2 方法 全部标本均是术中送检未固定新鲜组织,选取可疑区域取材2～4块,立即置Shandon Excelsior恒冷切片机内,-25℃冰冻5min,切片5～6μm,甲醇固定,HE染色,光镜观察。剩余组织常规做石蜡切片作为对照。石蜡切片诊断标准参考文献