摘要
目的:探讨术中冰冻病理对肺结节的诊断价值及手术切除指导意义。方法:回顾性选择2023年1月-2024年6月于抚州市第一人民医院进行手术治疗的肺结节患者108例。记录术中冰冻病理与常规病理的肺结节诊断结果、风险病灶评估结果,并评估术中冰冻病理指导手术切除的价值。结果:以常规病理检查结果为金标准。术中冰冻病理诊断非典型腺瘤样增生的准确率为90.00%(9/10),诊断原位腺癌的准确率为90.32%(28/31),诊断微浸润性腺癌的准确率为78.13%(25/32),诊断浸润性腺癌的准确率为97.14%(34/35)。以高风险病灶为阳性。术中冰冻病理诊断高风险病灶的阴性预测值为98.59%(70/71),阳性预测值为91.89%(34/37),敏感度为97.14%(34/35),特异度为95.89%(70/73),准确度为96.30%(104/108)。肺叶切除联合淋巴结清扫患者中,术中冰冻病理诊断高风险病灶37例,低风险病灶1例,常规病理确诊高风险病灶34例,低风险病灶3例。肺段切除/楔形切除患者中,术中冰冻病理诊断低风险病灶70例,常规病理确诊低风险病灶70例,高风险病灶1例。结论:术中冰冻病理诊断浸润性腺癌的准确率较高,对手术切除范围的指导有一定的临床意义。
Objective:To investigate the diagnostic value of intraoperative frozen pathology for pulmonary nodules and its guiding significance in surgical resection.Method:A total of 108 patients with pulmonary nodules who underwent surgical treatment in the First People's Hospital of Fuzhou City from January 2023 to June 2024 were selected retrospectively.The diagnostic results of pulmonary nodules and the evaluation results of risk lesions by intraoperative frozen pathology and routine pathology were recorded,and the value of intraoperative frozen pathology in guiding surgical resection was evaluated.Result:The results of routine pathological examination were taken as the gold standard.The accuracy rate of intraoperative frozen pathology in diagnosing atypical adenomatous hyperplasia was 90.00%(9/10),the accuracy rate in diagnosing adenocarcinoma in situ was 90.32%(28/31),the accuracy rate in diagnosing minimally invasive adenocarcinoma was 78.13%(25/32),and the accuracy rate in diagnosing invasive adenocarcinoma was 97.14%(34/35).High-risk lesions were positive.The negative predictive value of intraoperative frozen pathology diagnosis of high-risk lesions was 98.59%(70/71),the positive predictive value was 91.89%(34/37),the sensitivity was 97.14%(34/35),the specificity was 95.89%(70/73),and the accuracy was 96.30%(104/108).Among the patients with pulmonary lobectomy combined with lymph node dissection,37 cases of high-risk lesions and 1 case of low-risk lesion were diagnosed by intraoperative frozen pathology,34 cases of high-risk lesions and 3 cases of low-risk lesions were confirmed by routine pathology.Among the patients with pulmonary segmentectomy/wedge resection,70 cases of low-risk lesions were diagnosed by intraoperative frozen pathology,70 cases of low-risk lesions and 1 case of low-risk lesions were confirmed by routine pathology.Conclusion:The accuracy rate of intraoperative frozen pathology diagnosis of invasive adenocarcinoma is relatively high,and it has certain clinical significance for guiding the surgical resection range.
作者
邹丽
ZOU Li(Department of Pathology,the First People's Hospital of Fuzhou City,Fuzhou 344000,China)
出处
《中国医学创新》
2025年第21期119-122,共4页
Medical Innovation of China
关键词
术中冰冻病理
肺结节
手术切除
诊断价值
Intraoperative frozen pathology
Pulmonary nodules
Surgical excision
Diagnostic value
