甲状腺肿瘤的病理诊断与分析.docVIP

甲状腺肿瘤的病理诊断与分析 　　【摘要】 目的：分析甲状腺肿瘤的病理分布特征，评价不同免疫组化定性诊断良恶性肿瘤的效用。方法：选择医院2011年2月-2014年4月收治的甲状腺结节患者190例作为研究对象，所有患者均经超声扫查、穿刺活检诊断，术后获取标本，进行镜检病理学检查、免疫组化，病理科医师与超声医师共同进行病理诊断。结果：良性肿瘤占24.74%，甲状腺结节肿瘤占57.45%，甲状腺腺瘤42.55%，恶性肿瘤占75.26%，其中乳头癌占83.92%，滤泡癌占11.89%，髓样癌占0.70%，未分化癌占3.50%，其中乳头癌中经典型占55.00%，滤泡型占16.67%，隐匿型占27.50%，嗜酸细胞性0.83%；乳头癌CK19表达阳性率高于其他肿瘤，比较差异有统计学意义（P0.05）；良性肿瘤hTERT、Ki67、VEG、Ret、P53表达阳性率低于恶性肿瘤，比较差异均有统计学意义（P0.05）。结论：甲状腺肿瘤手术患者恶性肿瘤比重较高，其中多见乳头癌，乳头癌中不经典类型比重较高，免疫组化是定性诊断甲状腺肿瘤的重要方法，采用多种恶性肿瘤基因组化可提高诊断效用。 　　【关键词】 甲状腺肿瘤； 病理诊断； 免疫组化 　　【Abstract】 Objective：To analyze the pathological distribution characteristics of thyroid tumor and to evaluate the utility of different immunohistochemical qualitative diagnosis for benign and malignant tumors.Method：190 patients with thyroid nodules in the hospital from February 2011 to April 2014 were selected as the research objects.All patients were diagnosed by ultrasound scan and aspiration biopsy.Postoperative specimens were used for microscopy pathology examination and immunohistochemical.Pathological diagnosis was conducted by pathologists and ultrasound doctors.Result：Benign tumors accounted for 24.74%，swollen thyroid nodule accounted for 57.45%，thyroid adenoma accounted for 42.55%.Malignant tumor accounted for 75.26%，including papillary carcinoma 83.92%，follicular carcinoma 11.89%，medullary carcinoma 0.70%，undifferentiated carcinoma 3.50%.Among the papillary carcinoma，classical type accounted for 55.00%，follicular type accounted for 16.67%，latent accounted for 27.50%，acidophil accounted for 0.83%.The positive expression rate of CK19 in papillary carcinoma was higher than that in other tumors，the difference was statistically significant（P0.05）.The positive expression rates of hTERT，Ki67，VEG，Ret and P53 in benign tumors were lower than those in the malignant tumors，the differences were all statistically significant（P0.05）.Conclusion：The proportion of malignant tumor in patients with thyroid surgery is higher，among them papillary carcinoma is m