甲状腺冰冻切片与石蜡切片病理检查在甲状腺疾病中的诊断价值

Diagnostic Value of Frozen Section and Paraffin Section Pathological Examination in Thyroid Diseases

目的研究甲状腺冰冻切片与石蜡切片病理检查在甲状腺疾病中的诊断价值。方法选取2020年1月-2022年12月我院诊治的594例甲状腺疾病患者为研究对象,均进行甲状腺手术冰冻切片与石蜡切片病理检查,比较两种切片病理诊断时间、诊断不同甲状腺疾病(良性甲状腺肿瘤、恶性甲状腺肿瘤、非甲状腺肿瘤)准确率,以及冰冻切片病理诊断甲状腺疾病的诊断效能(敏感度、特异度)、冰冻切片病理诊断对甲状腺疾病筛查诊断准确率与石蜡切片病理结果的一致性。结果甲状腺石蜡切片病理诊断时间长于冰冻切片病理诊断时间(P<0.05);甲状腺石蜡切片病理诊断良性甲状腺肿瘤132例、恶性甲状腺肿瘤244例、非甲状腺肿瘤218例,冰冻切片病理诊断甲状腺疾病准确率为93.94%、延迟诊断率为1.35%、误诊率为4.71%;冰冻切片病理诊断良性甲状腺肿瘤、恶性甲状腺肿瘤、非甲状腺肿瘤的敏感度、特异度均大于80%;冰冻切片病理对甲状腺疾病(良性甲状腺肿瘤、恶性甲状腺肿瘤、非甲状腺肿瘤)筛查诊断准确率与石蜡切片病理结果具有高度一致性(Kappa=0.729、0.892、0.831,P=0.000、0.000、0.000)。结论甲状腺冰冻切片病理与石蜡切片病理检查在甲状腺疾病诊断中均具有重要的价值,与石蜡切片病理诊断比较,冰冻切片病理诊断可缩短诊断时间,并且获得与石蜡切片病理诊断较高的一致性,有效提高诊断效能、诊断准确率,值得临床应用。

Objective To study the diagnostic value of frozen section and paraffin section pathological examination in thyroid diseases.Methods A total of 594 patients with thyroid diseases diagnosed and treated in our hospital from January 2020 to December 2022 were selected as the research objects.All patients underwent frozen section and paraffin section pathological examination of thyroid surgery.The pathological diagnosis time of the two sections,the accuracy of diagnosis of different thyroid diseases(benign thyroid tumors,malignant thyroid tumors,non-thyroid tumors),the diagnostic efficacy(sensitivity,specificity)of frozen section pathological diagnosis of thyroid diseases,and the consistency of frozen section pathological diagnosis of thyroid disease screening and diagnostic accuracy with paraffin section pathological results were compared.Results The pathological diagnosis time of thyroid paraffin section was longer than that of frozen section(P<0.05).There were 132 cases of benign thyroid tumors,244 cases of malignant thyroid tumors and 218 cases of non-thyroid tumors diagnosed by pathological diagnosis of thyroid paraffin sections,the accuracy rate of frozen section pathological diagnosis of thyroid diseases was 93.94%,the delayed diagnosis rate was 1.35%,and the misdiagnosis rate was 4.71%.The sensitivity and specificity of frozen section pathological diagnosis of benign thyroid tumors,malignant thyroid tumors and non-thyroid tumors were all greater than 80%.The diagnostic accuracy of frozen section pathology for thyroid diseases(benign thyroid tumors,malignant thyroid tumors,non-thyroid tumors)was highly consistent with the pathological results of paraffin section(Kappa=0.729,0.892,0.831,P=0.000,0.000,0.000).Conclusion Frozen section and paraffin section pathological examination have important value in the diagnosis of thyroid diseases.Compared with paraffin section pathological diagnosis,frozen section pathological diagnosis can shorten the diagnosis time,and obtain higher consistency with paraffin section pathological diagnosis,effectively improve the diagnostic efficiency and diagnostic accuracy,which is worthy of clinical application.