甲状腺微小乳头状癌术中冰冻切片病理诊断准确性分析

Analysis of the Accuracy of Intraoperative Frozen Section Pathological Diagnosis for Papillary Thyroid Carcinoma

目的探究甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)采用术中冰冻切片病理诊断的价值。方法目的选取广东省农垦中心医院于2023年1—10月收治疑似甲状腺乳头状癌患者332例,对所有疑似患者分别实行两种诊断法,即术中冰冻切片病理检查、术后常规石蜡切片病理检查。术后常规石蜡切片检查结果作临床诊断金标准,统计并分析术中冰冻切片病理诊断结果与金标准的一致性。结果术后常规石蜡切片发现84例患者为PTMC,非PTMC患者248例,术中冰冻切片病理发现PTMC 71例,非PTMC 261例,术中冰冻切片的准确率为95.48%(317/332)、灵敏度是83.33%(70/84)、特异度是99.60%(247/248),Kappa值为0.784。结论术中冰冻切片病理诊断对PTMC的准确性与术后常规石蜡切片病理诊断结果具有较高的一致性,表明其对PTMC的诊断效果良好。

Objective To explore the diagnostic value of intraoperative frozen section pathology in papillary thyroid microcarcinoma(PTMC).Methods A total of 332 patients suspected of having papillary thyroid carcinoma,admitted to Guangdong Agricultural Reclamation Center Hospital from January to October 2023 were purposefully selected.All patients underwent two diagnostic methods:intraoperative frozen section pathological examination and postoperative routine paraffin section pathological examination.The results of the postoperative routine paraffin section were used as the gold standard for clinical diagnosis.The consistency between the intraoperative frozen section pathology and the gold standard was statistically analyzed.Results Postoperative routine paraffin sections identified eighty-four cases of PTMC and 248 cases of non-PTMC.Intraoperative frozen sections diagnosed seventy-one cases of PTMC and 261 cases of non-PTMC.The accuracy of intraoperative frozen section pathology was 95.48%,with a sensitivity of 83.33%and a specificity of 99.60%,and the Kappa value was 0.784.Conclusion Intraoperative frozen section pathological diagnosis shows a high degree of consistency with postoperative routine paraffin section diagnosis in PTMC,demonstrating good diagnostic accuracy for PTMC.