Analysis of intraoperative frozen pathological diagnosis of pulmonary nodules
肺结节的术中冰冻病理诊断应用分析

摘要

目的 分析肺结节采用术中冰冻病理检查进行诊断的准确率，为临床治疗提供有效依据。方法选取我院于2022年3月-2023年3月时间段内通过手术切除并送术中冰冻病理诊断的135例肺结节病例作为研究样本，对术中冰冻病理诊断结果与术后石蜡切片，以及免疫组化病理诊断结果进行分析对比。结果 术中冰冻病理检查诊断肺结节良恶性准确率为98.52%，135例肺结节病例中，2例未做出明确诊断，术后经石蜡切片诊断1例为不典型腺瘤样增生，1例为肺腺癌；术中冰冻病理检查诊断肺恶性病变准确率为84.82%，其中肺腺癌诊断准确率较高，为87.50%。神经内分泌肿瘤诊断准确率较低，为66.67%。1例转移癌未做出明确分型诊断；术中冰冻病理检查诊断肺良性病变准确率为95.65%，1例硬化性肺细胞瘤未做出具体分型诊断。结论 绝大部分良、恶性肺结节可通过术中冰冻病理检查进行准确诊断，少部分冰冻诊断困难病例可通过复习病史、结合快速免疫组化技术等，提升术中冰冻病理诊断效能，为手术方案的调整提供有效依据。

Abstract

Objective To analyze the accuracy of intraoperative frozen pathological examination for the diagnosis of pulmonary nodules and provide effective basis for clinical treatment.
Methods 135 cases of pulmonary nodules were selected from our hospital during the period of March 2022 to March 2023, which underwent surgical resection and intraoperative frozen pathological diagnosis. The results of intraoperative frozen pathological diagnosis, postoperative paraffin sections, and immunohistochemical pathological diagnosis were analyzed and compared.
Results The accuracy of intraoperative frozen pathological examination in diagnosing benign and malignant pulmonary nodules was 98.52%. Out of 135 cases of pulmonary nodules, 2 cases were not clearly diagnosed. After surgery, paraffin sections were performed to diagnose 1 case as atypical adenomatous hyperplasia and 1 case as lung adenocarcinoma; The accuracy rate of intraoperative frozen pathological examination in diagnosing malignant lung lesions was 84.82%, with a higher diagnostic accuracy rate of 87.50% for lung adenocarcinoma. The diagnostic accuracy of neuroendocrine tumors is relatively low, at 66.67%. One case of metastatic cancer did not make a clear classification diagnosis; The accuracy rate of intraoperative frozen pathological examination in diagnosing benign lung lesions was 95.65%, and no specific classification diagnosis was made for one case of sclerosing pulmonary cell tumor.
Conclusion   The vast majority of benign and malignant pulmonary nodules can be accurately diagnosed through intraoperative frozen pathological examination. A small number of cases with difficulty in frozen diagnosis can be improved through reviewing medical history, combined with rapid immunohistochemistry technology, etc., to improve the diagnostic efficiency of intraoperative frozen pathological examination and provide effective basis for adjusting surgical plans.