甲状腺肿块术中冰冻切片诊断的初探

1983年12月～1991年12月间我科共计有392例甲状腺肿块病人接受术中冰冻切片检查,其中15例冰冻切片与术后石蜡切片结果不符,占3.8％;3例术中冰冻切片未得结果,占0.8％,作者分析了术中冰冻切片与术后石蜡切片结果不符的可能因素,对甲状腺肿块术中冰冻切片的应用价值及注意事项提出了自己的看法。     

快速切片953例诊断结果分析

快速切片９５３例诊断结果分析张晓岚石麒麟１材料和方法回顾分析我科１９８１～１９９６年快速切片９５３例，其中快速石蜡切片７１０例，恒冷冰冻切片２４３例，诊断结果分为确诊、未能确诊和误诊３类。２结果男性３４７例，女性６０６例，年龄５～７９岁，平均３６．５...     

基于冷冻切片的直接免疫组化染色法在甲状腺乳头状癌中的诊断价值

目的 探讨基于冷冻切片的直接免疫组化染色法在甲状腺乳头状癌中的诊断价值.方法 收集手术中送检的甲状腺良性病变组织、乳头状癌组织各30例,采用直接免疫组化染色法、石蜡切片免疫组化染色法检测CK19、Galectin-3的表达,对比两种染色法的时间、质量、阳性率及诊断准确率.结果 直接免疫组化染色法耗时15 min,石蜡切...     

手术中冰冻切片诊断卵巢肿瘤859例分析

目的：总结部冻切片诊断卵巢肿瘤的体会。方法：回顾性分析８５９例卵巢肿瘤冰冻切片诊断资料．结果：利用冰冻切片诊断卵巢肿瘤，确诊率９４．８８％，未能确诊率０．５８％，误诊率４．５４％。误诊３９例，多见于交界性粘液囊腺瘤，分化好粘液囊腺癌和转移性粘液腺癌；４例冰冻切片误诊的良性肿瘤包括２例卵巢甲状腺种和２例粘液囊腺瘤。误诊原因中，取材不当占５３．８８％，读片错误３５．９０％，制片不良１０．２８％。结论：     

快速冰冻切片对异位妊娠诊断价值的初探

目的：探讨快速冰冻切片对临床可疑宫外孕患者的诊刮标本中是否带有胚胎产物检查的准确性，以协助异位妊娠的诊治。方法：对可疑子宫内膜诊刮标本的冰冻切片、石蜡切片及临床资料进行回顾性分析，若最后石蜡切片病理诊断与冰冻切片一致，则认为冰冻切片正确。结果：其中８５例（８５／９１，９３．４％）快速冰冻切片诊断是正确的，冰冻切片的敏感性为７９．２％，特异性为９８．５％，其阳性、阴性预测值分别为９５％、９３％。结论：快速冰冻切片在判断临床怀疑宫外孕患者的子宫内膜诊刮标本确定有无胚胎产物方面有很好的准确性，是一项很有临床实用价值的方法。     

石蜡切片与冰冻切片在胰腺原位杂交中的应用与比较

石蜡切片与冰冻切片在胰腺原位杂交中的应用与比较赵春芳，李枫，郭雯媛（河北医科大学组织胚胎教研室石家庄０５００１７北京医科大学组胚系北京１０００８３）胰腺经石蜡包埋，切片在原位杂交过程中不易脱片，而且能较好地保存组织中的ＲＮＡ和微细结构。１材料与方法取...     

657例乳腺病变快速冰冻切片病理诊断分析

目的探讨快速冰冻切片在乳腺病变诊断中的临床意义及延迟诊断的原因。方法回顾性分析我院自2004年1月-2008年12月657例乳腺手术中快速冰冻切片的病理诊断资料。结果657例乳腺病变冰冻切片中，确诊病例643例（97．87％），延迟诊断14例（2．13％），无误诊病例。643例确诊病例中，恶性肿瘤394例（61．28％），良性肿瘤78例（12．13％），非肿瘤性病变171例（26．59％）。结论充分肯定快速冰冻切片在乳腺病变诊断中的意义；当冰冻切片中良恶性难以确定时，延迟诊断是必要的。     

93例卵巢肿瘤冰冻切片病理诊断分析

冰冻切片病理诊断有利于手术医师在术中获得正确及时的诊断，选择下一步适宜的手术方案。但由于这项工作是在短时间内完成，受取材制片因素影响较大，常给诊断带来困难，为了提高冰冻切片病理诊断的正确率，对９３例卵巢肿瘤术中冰冻片进行回顾性分析，以期总结经验，提高...     

提高病理冰冻切片质量的体会

目的通过自身的工作体会,探讨提高冰冻切片质量的技巧及方法.方法对乳腺、子宫、甲状腺、胃肠等几种不同组织进行冰冻切片比较、观察.结果切片完整,厚薄均匀,染色核浆对比鲜明,细胞形态及组织结构清晰,符合术中快速冰冻诊断要求.结论一张优质的冰冻切片需要技术员对不同的组织区别对待,从取材、冷冻、切片、固定、染色等环节认真做起.     

γ-GT酶组织化学染色中低熔点石蜡切片代替冰冻切片的方法

酶组织化学染色的效果取决于标本组织中酶的含量和活性 ,标本组织的处理及制片过程对于酶的保存十分重要。常规石蜡切片因组织浸蜡温度高 ,易使酶变性 ,因此酶组织化学染色通常选用冰冻切片。寻找一种较理想的切片方法 ,是研究人员的迫切愿望和要求 ,我们在谷氨酰转肽酶 (γ -ＧＴ)染色中 ,摸索采用低熔点石蜡切片代替冰冻切片 ,取得了良好的效果 ,现介绍如下 :1　材料与方法正常兔肾新鲜标本 ,①冰冻切片 :取 1ｃｍ× 0 5ｃｍ×0 2ｃｍ组织 ,立即放入 - 2 0℃恒冷冰冻切片机 ,冷冻 10ｍｉｎ ,切片厚 8μｍ ,放 4℃冰箱备用 ;②低熔点石蜡…     

A meta-analysis of comparing fine-needle aspiration and frozen section for evaluating thyroid nodules

The literature on comparing fine-needle aspiration (FNA) and frozen section for evaluating thyroid nodules was reviewed. Publications on this subject were divided into three groups (follicular lesions, non-follicular lesions and thyroid lesions, not otherwise specified). A meta-analysis was done to compare sensitivity, specificity, and positive and negative predictive values between FNA and frozen section diagnoses. For follicular lesions, FNA was much more sensitive but less specific, with lower positive predictive value than frozen section. FNA and frozen section are virtually identical in all parameters of accuracy in evaluating thyroid nodules that are not follicular lesions. The third group of publications that did not separate/specify follicular lesions from non-follicular lesions was non-contributory.     

Synchronous papillary thyroid carcinoma and follicular thyroid carcinoma: case report and review of literature

Collision tumor is a term denoting two histologically distinct tumor types occuring at the same anatomic site, which is a rare clinical entity. In the thyroid gland, collision tumors are rare. Here we report a case of the synchronous occurrence of follicular thyroid carcinoma (FTC) and papillary thyroid carcinoma (PTC). The current case report describes a 40-year-old woman with synchronous FTC and PTC. Pathologists and surgeons should be aware of collision tumors to avoid possible misdiagnosis.     

新疆地区4998例乳腺病变冷冻切片延迟诊断及误诊回顾性分析

目的探讨乳腺病变中冷冻切片诊断引起延迟诊断及误诊的原因,旨在提高乳腺冷冻诊断的准确性。方法回顾性分析2010~2015年乳腺病变术中冷冻切片4 998例,以石蜡切片作为诊断的最终结果与冷冻诊断结果进行对照。结果乳腺病变术中冷冻标本平均每年999.6例,符合诊断共4 970例(99.44%),其中良性病例4 726例(94.56%),恶性病例272例(5.44%);延迟诊断16例,占总例数的0.32%;假阴性11例,假阳性1例,分别占总例数的0.22%和0.02%。导管上皮不典型增生、假浸润、腺病伴导管上皮增生、硬化性腺病和乳腺神经内分泌癌在冷冻组织形态上易导致延迟或误诊。结论女性乳腺病变就诊意识提高,乳腺病变组织形态多样,冷冻切片取材局限、冷冻切片质量不一、病理医师自我保护意识提高等因素是造成延迟和误诊的原因,加强病理医师诊断技术,提高冷冻切片质量,与外科及时沟通、协作对减少延迟和误诊有重要作用。     

Tumor-specific deposition of immunoglobulin G and complement in papillary thyroid carcinoma

Despite its predilection for multifocal growth and regional metastasis, papillary thyroid carcinoma (PTC) is a clinically indolent malignancy with an exceptionally favorable long-term prognosis. Together with the often striking inflammatory reaction present in PTC, its quiescent behavior has been suggested to reflect the activation of a tumor-induced immune response. To examine this possibility, we have studied the deposition of immunoglobulins and complement in PTC tissue. Samples from 70 cases of neoplastic and autoimmune thyroid diseases, including PTC (n = 41), follicular, anaplastic, and medullary carcinomas (n = 12), follicular adenoma (n = 6), Graves' disease (n = 8), and Hashimoto's thyroiditis (n = 3) were analyzed immunohistochemically. Cellular deposits of immunoglobulin G (IgG), particularly subclasses IgG₁ and IgG₄, and complement factors C3d, C4d, and C5 were shown in up to 80% of the PTC cases, whereas the other thyroid diseases studied showed little or no cellular deposition. Nonneoplastic tissue of PTC-containing thyroid glands (n = 22) lacked staining for IgG in 50% of the cases, and 82% were devoid of complement. The results suggest a tumor-specific immune response in PTC with activation of the classical complement cascade.     

Use and abuse of frozen section in the diagnosis of follicular thyroid lesions

The role of intraoperative frozen section in certain organ systems such as the thyroid continues to be problematic. In many cases, diagnoses are deferred or nonhelpful—“follicular lesion.” In the modern era, the widespread use of preoperative aspiration biopsy has allowed for more careful selection of patients who undergo thyroid surgery. In many cases, the fine-needle-aspiration (FNA) biopsy diagnosis can be definitive or can guide the specific surgical procedure. The literature supports our approach, which is summarized as follows: Intraoperative consultation is not needed on the intrathyroidal nodule if a preoperative FNA was definitive for papillary carcinoma. Frozen section is of no value in the intraoperative diagnosis of lesions diagnosed on FNA as “follicular neoplasm” or “Hürthle cell neoplasm” because the characterization of these lesions requires detailed analysis of the tumor capsule for the demonstration of capsular and/or vascular invasion—an analysis that is not practical in the intraoperative setting. Finally, intraoperative consultation including frozen section and intraoperative cytologic examination is most useful in those cases that are diagnosed as suspicious for papillary carcinoma by FNA, because the assessment of nuclear features needed for the definitive diagnosis is possible with intraoperative techniques in a significant number of cases.     

Use of frozen section in genitourinary pathology

Frozen section diagnosis provides critical information for immediate surgical management decision making. Over the last several years, there have been some significant advances in treatment of genitourinary cancer, particularly with regard to surgical techniques. These changes in turn impact the type and frequency of intraoperative frozen section requests. In this review, we describe the main indications and diagnostic challenges of frozen section diagnosis during surgeries of each genitourinary organ system including prostate, kidney, bladder, testis, and penis. The pitfalls and approaches to different diagnostic situations are discussed. It is also stressed that pathologists must not only be familiar with the histological diagnosis, but also understand the limitations of frozen section diagnosis and communicate with urologists during the intraoperative treatment decision making process.     

阳离子微电流检测仪在甲状腺肿瘤术中诊断的应用

目的探讨手术中快速定性诊断甲状腺肿瘤的新方法。方法随机选择手术中切除的新鲜甲状腺病变组织标本100例,其中男性20例,女性80例;年龄20～70岁,平均年龄47.35岁。诊断良性病变95例,恶性肿瘤5例。同步应用肿瘤检测仪阳离子微电流检测法与冷冻切片法、石蜡切片法进行比较诊断。仪器检测标本放入37℃恒温水浴锅中复温1～3 min取出,将探头置于组织上,仪器荧屏可见移动的红黑两条并行曲线。设定红线0μA为标准线,黑色曲线为检测线,判断标准:检测值<0μA为良性病变,>0μA为恶性病变,0～-3μA为交界性病变。检测后对病变组织标本分别编号,再与常规石蜡切片诊断对比分析。结果应用阳离子微电流检测法与冷冻切片法进行定性诊断,在100例甲状腺病变组织材标本中,仪器检测与冷冻切片诊断结果对比,良性肿瘤中有1例不符合(99/100),准确率99%;与石蜡切片诊断对比有2例不一致(98/100),符合率98%。结论手术中应用肿瘤检测仪阳离子微电流检测法对甲状腺良性与恶性肿瘤可快速做出认定,准确度高,与冷冻切片及石蜡切片诊断一致性好。