甲状腺癌26例误诊误治原因探讨

Diagnosis and treatment errors of thyroid carcinoma in 26 cases

目的探讨甲状腺癌误诊误治的原因,以及避免误诊误治的方法.方法回顾1997～2004年68例甲状腺癌中误诊的26例临床资料,结合文献进行分析.结果误诊率达38.2%(26/68).误诊病例中,术前CT检查8例、细针穿刺细胞学检查3例,术中快速冰冻切片检查5例.再手术18例.结论甲状腺癌误诊率高,且常被误治.对甲状腺肿块术前未行穿刺细胞学检查和术中未行快速冰冻切片是甲状腺癌误诊误治的最主要原因.常规术前细胞学检查和术中冰冻切片检查,有利于确诊及正确的术式选择.

Objective To investigate the causes of misdiagnosis and resultant treatment in error in patients suffering from thyroid carcinoma and evaluate ways of avoiding the misdiagnosis. Methods 26 missed cases with thyroid carcinoma from 1997 to 2004 were gathered and reviewed for retrospective study and the data together with the literature concerned were analysed for detecting the causes. Results The results suggested that misdiagnosis rate was 38.2% （26/68）. 8 cases（8/26）received CT scanning, 3 cases（3/26） were performed FNAB detection before operation and quick frozen pathologic section（5/26） in operation was low. 18 cases were experienced second surgery. Conclusion The key to sound diagnosis and rational treatment should include FNAB detection before operation and quick frozen pathologic section in operation.