264例甲状腺滤泡性病变手术中病理诊断结果分析

The pathological diagnosis results analysis of 264 cases with thyroid follicular lesions in operation

目的探讨甲状腺滤泡性病变手术中病理诊断技巧,提高手术中病理诊断准确性。方法回顾264例甲状腺滤泡性病变大体观察、冷冻切片、印片细胞学特征和常规石蜡切片诊断,分析误诊、延迟的原因。结果 264例甲状腺滤泡性病变,手术中病理诊断确诊255例(96.59%),延迟诊断6例,误诊3例(假阳性1例,假阴性2例),其中甲状腺滤泡型乳头状癌印片细胞学的细胞核形态特征清晰,可协助冷冻切片诊断。结论联合大体观察、冷冻切片和印片细胞学,可对大多数甲状腺滤泡性病变做出正确的手术中病理诊断,尤其适合提高基层医院手术中病理诊断的准确率,甲状腺滤泡性癌少见且通常需要待石蜡切片确诊。

Objective To explore and discuss the pathologic diagnosis skills of thyroid follicular lesions in operation was to improve theaccuracy of intraoperativepathological diagnosis.Methods 264 thyroid follicular lesions patients’gross observation, frozen sections, impressed specimenscytology features and traditional paraff in sections were diagnosed retrospectively, so as to analyze the reasons of misdiagnosis and delayed diagnosis. Results Among 264 cases with thyroid follicular lesions, in the intraoperative pathologic diagnosis, there were255 cases of diagnosed （96.59%）, 6 cases of delayed diagnosis, and 3 cases of misdiagnosis （1 caseof false positives, 2 cases of false negative）, the clear nucleus morphological characteristics of printed cytology of thyroid follicular variant of papillary carcinoma could assist frozen sections diagnosis.Conclusion Combining with the gross observation, cryostat section and printed cytology could make correct in traoperative pathological diagnosis formost thyroid follicular lesions, which was particularly suited to improve the accuracy of intraoperative pathological diagnosis in grassroots hospital. The thyroid follicular carcinoma was rare, which usually needed paraff in section to diagnose.