甲状腺腺瘤和单纯结节性甲状腺肿的临床病理特征分析

目的]探讨甲状腺腺瘤(TA)和单纯的结节性甲状腺肿(NG)的临床病理特征及细针穿刺对两者诊断及鉴别的价值.方法]收集经本院手术病理证实为甲状腺疾病患者734例的病案资料,按照WHO最新病理分类标准对其进行以病理形态学为主的复验和分析.结果]复验结果显示,734例甲状腺疾病患者中,结节性NG178例,TA368例,甲状腺癌84例,甲状腺炎40例,弥漫性毒性甲状腺肿62例,淋巴瘤2例,与复验前比较结节性NG增加18例,而TA减少18例,其余无变化;术中冷冻切片诊断对病变恶性程度的判断准确率为100%,定类准确率为88.24%;细针穿刺诊断的准确率较低,仅为77.78%(70/90),其中对甲状腺滤泡性癌的诊断最为困难.结论]TA和单纯NG大多都存在囊性变,病理鉴别诊断较困难,细针穿刺活检诊断的准确率不高,需要结合病史及实验室检查结果方能作出准确的诊断.

Thyroid Adenoma and Nodular Goiter in Clinical Pathological Diagnosis Research

Objective]To analyze the clinical pathological features and fine needle aspiration diagnosis of thy-roid adenoma(TA)and single nodular goiter(NG).Methods]Data of 734 cases of thyroid diseases confirmed by operation and pathology in our hospital were collected.According to the latest pathological classification standard of WHO,the re analysis and analysis were mainly based on the pathological morphology.Results]The results of the re examination showed that in 734 cases of thyroid diseases,nodular NG cases 178,TA cases 368,thyroid cancer 84cases,thyroiditis 40cases,diffuse toxic goiter 62 cases,Lymphoma 2 cases;compared with the prior ex-amination,nodular NG increased in 18 cases,while TA reduced in 18 cases,the rest remained unchanged;the ac-curacy of intraoperative frozen section diagnosis was 100%,and the accurate rate was 88.24%.The accuracy of fine needle aspiration diagnosis was low,only 77.78%(70/90),whereas the diagnosis of thyroid follicular carcino-ma was the most difficult.Conclusion]Most of TA and single nodular NG have cystic changes,and the pathologi-cal differential diagnosis is difficult,therefore the accuracy of fine needle aspiration biopsy is not so high.Thus an accurate diagnosis should be made in combination with the history and laboratory findings.