367例甲状腺疾病临床病理诊断分析

Clinicopathological diagnosis of thyroid diseases: analysis of 367 cases

目的 :总结甲状腺腺瘤和单结节性甲状腺肿的鉴别诊断、细针穿刺诊断在甲状腺疾病中的应用经验和价值 ,旨在提高甲状腺疾病的诊断和鉴别诊断水平。方法 :对 367例甲状腺病变进行病理形态学为主的复验和结果分析。结果 :甲状腺疾病中女性患者占 82 6% ;各类疾病中甲状腺腺瘤占首位 (5 0 1% ) ;术中冷冻切片对甲状腺良恶性疾病诊断 (定性 )的符合率为10 0 % ,具体类型诊断 (定类 )符合率为 88 2 % ;细针穿刺诊断准确率为 77 8%。结论 :应重视甲状腺腺瘤与单结节性甲状腺肿的鉴别诊断 ;甲状腺疾病 ,尤其是甲状腺恶性疾病的细针穿刺诊断准确率低 。

Purpose To review clinicopathological diagnosis of 367 cases of thyroid diseases and to summarized the distinction between thyroid adenoma and nodular goiter, the diagnostic points of thyroid follicular carcinoma and the value of fine needle aspiration(FNA) in thyroid disease diagnosis. Methods 367 thyroid cases were reviewed and analyzed with standard histopathologic methods. Results Of the 367 cases, female accounted for 82 6%; thyroid adenoma accounted for 50 1% which was the most portion of thyroid disease; the diagnosis of frozen sections accorded with that of paraffine section by 100% in quality but 88 2% in accuracy; the precision of FNA was 77 8%. Conclusions It is important to emphasize that thyroid adenoma should be differentiated from nodular goiter. The accurateness of FNA is not satisfied for dianosis of thyroid tumor, especially thyroid follicular carcinoma, so it can not replace the frozen section.