1 138例肺部肿物术中冰冻诊断结果分析

通过对1 138例肺部肿物的冰冻切片进行回顾性分析，探讨术中冰冻对肺部肿物诊疗的价值。方法:收集并整理1 138例肺部肿物术中冰冻切片及其诊断结果，并与相应石蜡切片及诊断结果进行比较，总结分析肺部肿物冰冻诊断的特点和常见误诊原因。结果:1 138例肺部肿物的术中冰冻诊断准确率为96.2%（1 094/1 138），误诊率为3.8%（44/1138）；误诊比例最高的三个病种分别为炎性假瘤（31.8%）、硬化性血管瘤（18.1%）及结核病（13.6%）。结论:术中冰冻切片诊断对肺部肿瘤的性质确定具有重要意义。正确的冰冻诊断需要全面的临床资料和足够的病变组织；病理医师要有良好的病理基础和冰冻切片诊断的丰富经验及较全面的临床、影像学知识才能保证诊断的可靠性。 

Analysis of the Diagnosis of 1,138 Frozen Sections of Lung Cancer

Abstract　Objective: To discuss the value of the frozen technique in diagnosing and treating lung cancer through retrospective analysis of 1,138 cases with frozen sections of lung tumor. Methods: The intra-operative frozen section and diagnostic results of these cancer cases were collected and sorted, and then were compared with relevant paraffin sections and diagnoses of other cases. The characteristics of the frozen section and common causes of misdiagnosis of lung tumor were summarized. Results: The rate of intra-operative diagnostic accuracy and the misdiagnosis rate was 96.2% ( 1094/1138 ) and 3.8% ( 44/1138 ) in the 1,138 cases, respectively. The three diseases that ranked the highest in misdiagnosis were inflammatory pseudotumor ( 31.8%), sclerosing hemangioma ( 18.1% ), and tuberculosis ( 13.6% ). Conclusion: Diagnosis by intra-operative frozen section is extremely significant in determining the nature of lung cancer. Correct diagnosis requires comprehensive clinical data and sufficient diseased tissue. A good, common onco-pathologic basis, rich experiences in diagnosis with frozen section, and comprehensive clinical and diagnostic imaging knowledge of pathologists are necessary to ensure the reliability of diagnosis of cancer.