甲状腺微小癌的快速冷冻切片诊断及免疫组化分析

目的 提高冷冻切片甲状腺微小癌（TMC）的检出率。方法 对42例冷冻切片诊断的TMC进行光镜观察，其中20例做免疫组化标记。结果 42例均为甲状腺乳头状微小癌，主要组织学特征为核内包涵体、毛玻璃样核、核沟、纤维性间质和砂砾体。免疫组化甲状腺球蛋白（TG）、细胞角蛋白19（CK19）均强（＋），癌旁滤泡和良性增生性乳头CK19（-）；17例上皮膜抗原（EMA）（＋），8例CEA（＋）。结论 TMC的诊断主要依据组织病理学和免疫组化标记，CK19的阳性表达有助于TMC的诊断和鉴别诊断。

Diagnosis of thyroid microcarcinoma by frozen sections and immunohistochemistry

Objective To improve the detected rate of the thyroid microcarcinoma(TMC) by frozen sections.Methods 42 cases of(TMC) were investigated by light microscopy,and 20 cases of them were studied with immunohistochemical staining.Results All cases were thyroid papillary microcarcinoma.The main histopathologic features were nuclear pseudoinclusion,ground glasslike nuclei,nuclear groove,psammoma bodies and fibrous stromal reactions.The immunohistochemical results showed positive thyroglobin(TG) and cytokeratin 19(CK19) in 20 cases.17 cases were positive for EMA,and 8 cases,positive for CEA.CK19 were negative in adjacent thyroid tissue and beingn papillary hyperplasia tissue.Conclusion Diagnosis of TMC bases on its microscopic and immunohistochemical features.The positive expression of CK19 may facilitate the diagnosis and differential diagnosiS of TMC.