术中冰冻切片病理检查诊断甲状腺微小癌的价值分析

Value Analysis of Pathological Examination Using Intraoperative Frozen Sections in Diagnosis of Thyroid Microcarcinoma

目的:分析术中冰冻切片病理检查诊断甲状腺微小癌的价值。方法:选取2020年10月—2023年12月于六盘水市盘州市第二人民医院进行甲状腺手术的患者184例作为研究对象,均进行术中冰冻切片病理检查、术后冰冻石蜡切片病理检查,以术后冰冻石蜡切片病理检查为“金标准”,评估术中冰冻切片对甲状腺微小癌的诊断价值。结果:术后冰冻石蜡切片病理检查结果显示,184例患者中阳性75例,阴性109例。术中冰冻切片病理检查诊断甲状腺微小癌漏诊3例,误诊2例(结节性甲状腺肿伴腺瘤样增生1例,甲状腺肿伴滤泡上皮乳头状增生1例)。术中冰冻切片病理诊断甲状腺微小癌的敏感度为96.00%(72/75),特异度为98.17%(107/109),准确度为97.28%(179/184),阳性预测值为97.30%(72/74),阴性预测值为97.27%(107/110)。结论:术中冰冻切片病理检查诊断甲状腺微小癌的价值较高,但仍存在一定漏诊、误诊情况,临床需采取应对措施,进一步提高诊断准确率。

Objective:To analyze the value of pathological diagnosis of intraoperative frozen sections for thyroid microcarcinoma.Methods:A total of 184 patients who underwent thyroid surgery in the Second People's Hospital of Panzhou City from October 2020 to December 2023 were selected as the study subjects.All patients underwent the pathological examinations using intraoperative frozen sections and postoperative frozen paraffin sections.The pathological examination using postoperative frozen paraffin sections was used as“golden standard”to assess the value of intraoperative frozen sections in diagnosis of thyroid microcarcinoma.Results:The results of pathological examination using postoperative frozen paraffin sections showed that 75 out of 184 patients were positive and 109 out of 184 patients were negative.The pathological examination using intraoperative frozen sections showed a missed diagnosis in 3 patients with thyroid microcarcinoma and a misdiagnosis in 2 patients(1 patient had nodular goiter with adenomatous hyperplasia,and 1 patient had goiter with follicular epithelial papillary hyperplasia).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of intraoperative frozen section pathological diagnosis for thyroid microcarcinoma were 96.00%(72/75),98.17%(107/109),97.28%(179/184),97.30%(72/74),and 97.27%(107/110),respectively.Conclusion:The pathological examination using intraoperative frozen sections has a high value in the diagnosis of thyroid microcarcinoma.However,the missed diagnosis and misdiagnosis are still present.Clinical measures are required to further increase the diagnostic accuracy.