甲状腺癌冰冻切片病理不能明确诊断的临床因素分析OA

Objective To investigate the occurrence of intraoperative frozen section(FS)pathology unclear diagnosis in thyroid carcinoma,seeking clinical factors affecting the pathological accuracy of FS.Methods Retrospective analysis of thyroid cancer patients who underwent surgical treatment at People's Hospital of Daxing District in Beijing from August 2016 to December 2019.Target nodules were divided into FS clear diagnosis group and unclear diagnosis group(including delayed diagnosis group,misdiagnosis group,accidental diagnosis group)according to the results of FS and paraffin section pathological examination.The general information,laboratory test,result of color ultrasound and pathological types between FS clear diagnosis group and unclear diagnosis group were compared.Results A total of 336 cancer nodules were included.The quantity and proportion of cancer nodules in clear diagnosis group,delayed diagnosis group,misdiagnosis group and accidental diagnosis group were respectively 266(79.17%),28(8.33%),21(6.25%)and 21(6.25%).In the delayed diagnosis group,"no exception"thyroid cancer was the most frequently used.Compared to clear diagnosis group,the maximum diameter of cancer nodules in delayed diagnosis group,misdiagnosis group,accidental diagnosis group were smaller(P<0.05);In the delayed diagnosis group,the proportion of aspect ratio>1 was higher(P=0.017),and the proportion of microcalification was lower(P=0.002).In the misdiagnosis group,thyroid peroxidase antibody level was higher(P=0.002).Conclusion Clinical doctors should be familiar with commonly used diagnostic terms for delayed diagnosis and misdiagnosis.When making treatment decisions,full consideration should be given to the possibility of difficult to diagnose diagnosis,especially for patients with small nodules and concurrent chronic lymphocytic thyroiditis.