细针穿刺细胞学检查联合免疫组化对甲状腺癌术前诊断准确率影响.docVIP

细针穿刺细胞学检查联合免疫组化对甲状腺癌术前诊断准确率影响 　　[摘要] 目的 ?^察分析细针穿刺细胞学检查联合免疫组化对甲状腺癌的术前诊断准确率的影响。 方法 回顾性分析2015年1月～2016年12月于我院就诊的甲状腺结节患者86例的临床资料，术前均进行细胞学检查，同时进行免疫组化分析，并与术后病理结果进行对比。 结果 术前细胞学诊断38例乳头状癌，18例滤泡性肿瘤，16例滤泡性病变，2例未分化癌。18例可疑恶性肿瘤患者采用免疫组化染色，其中7例乳头状癌，2例滤泡癌；术后病理结果：9例乳头癌，2例滤泡癌。16例可疑良性病变采用免疫组化染色，其中9例恶性肿瘤，术后病理结果得知，5例乳头癌，2例滤泡癌。术后病理检查得知，48例乳头癌，4例滤泡癌，9例未分化癌，25例结节性甲状腺肿。单个免疫组化标记物抗体Galectin-3、CK19、BRAF、HBME-1、TPO与联合标记在甲状腺癌诊断中的敏感性、准确性、特异性均较高；但与联合标记对比差异无统计学意义（P0.05）；细胞学检查联合免疫组化对诊断甲状腺结节的敏感性、准确性、特异性均显著高于细胞学检查（P0.05）。 结论 细针穿刺细胞学检查联合免疫组化能够有效提高甲状腺癌诊断准确性，可有效减少甲状腺癌的误诊与漏诊，有利于临床治疗与预后。 　　[关键词] 细胞学检查；免疫组化；甲状腺癌；术前诊断 　　[中图分类号] R736.1 [文献标识码] B [文章编号] 1673-9701（2018）09-0130-03 　　Effect of fine needle aspiration cytology combined with immunohistochemistry on the accuracy of preoperative diagnosis of thyroid cancer 　　PEI Zhijuan 　　Department of Pathology， Zhejiang Cancer Hospital， Hangzhou 310022， China 　　[Abstract] Objective To investigate the effect of fine needle aspiration cytology combined with immunohistochemistry on the accuracy of preoperative diagnosis of thyroid cancer. Methods The clinical data of 86 patients with thyroid nodules who were treated in our hospital from January 2015 to December 2016 were retrospectively analyzed. Cytology was performed on all participants before operation with immunohistochemical analysis conducted at the same time. The results were compared with postoperative pathological findings. Results 38 cases of papillary carcinoma， 18 cases of follicular tumor， 16 cases of follicular lesion and 2 cases of undifferentiated carcinoma were diagnosed using preoperative cytology. Immunohistochemical staining was used in 18 cases of suspected malignant tumor with 7 cases of papillary carcinoma and 2 cases of follicular carcinoma as a result. Postoperative pathology showed that， there were 9 cases of papillary carcinoma and 2 cases of follicular carcinoma. 16 cases of suspected benign lesions were immunohistochemistry， with 9 cases of malignant tumors as a results， while postope