甲状腺微小乳头状癌51例病理特征分析

Analysis of pathological features of 51 cases of papillary thyroid microcarcinoma

目的分析甲状腺微小乳头状癌病理诊断特征及免疫组化、分子检测在该肿瘤诊断中的意义。方法收集太和县人民医院病理科2012年2月-2020年7月术中快速冰冻及术后常规组织病理诊断为甲状腺微小乳头状癌的患者共51例,部分病例辅助免疫组化及分子检测。结果51例甲状腺微小乳头状癌中,术中冰冻诊断36例,诊断率为70.6%(36/51);冰冻剩余组织及常规HE染色共确诊42例,诊断率为82.4%(42/51);术中冰冻切片与常规HE诊断符合率为85.7%(36/42);4例免疫组化CK19(+)、MC(+)、Cyclin D1(+)、Galectin-3(+)辅助确立诊断;5例显示BRAF基因V600E突变确立诊断。结论甲状腺微小乳头状癌主要依靠冰冻切片,免疫组化及分子检测有助于提高甲状腺微小乳头状癌病理诊断的准确率。

Objective To analyse the features of pathological diagnosis in papillary thyroid microcarcinoma((PTM)and the clinical significance of immunohistochemical and molecular detection.Methods 51 patients with PTM from the department of pathology of Taihe County People􀆳s Hospital between Febuary 2012 and July 2020 were selected as the research subjects.Frozen pathological diagnosis was performed during the operation,and the results were compared with those of paraffin sections.Some of cases were detected by immunohistochemical and molecular methods.Results Among 51cases of PTM,36 cases of were diagnosed by intraoperative frozen section,and pathological diagnosis rate of frozen sec⁃tion was 70.6%(36/51).A total of 42 cases were confirmed by frozen residual tissue and routine HE staining,and the total diagnostic rate was 82.4%(42/51).The coincidence rate of intraoperative frozen section and conventional HE diagnosis was 85.7%(36/42).Additionally,4 cases were diagnosed by immunohistochemical CK19(+),MC(+),Cyclin D1(+)and Ga⁃lectin⁃3(+).5 cases were diagnosed by molecular detection of BRAF V600E mutation.Conclusion The diagnosis of PTM mainly depends on frozen section.Immunohistochemical and molecular detection are helpful to improve the accuracy of patho⁃logical diagnosis of PTM.