術(shù)中冰凍病理對(duì)肺結(jié)節(jié)的診斷價(jià)值及手術(shù)切除指導(dǎo)意義

打開文本圖片集

[Abstract]Objective： To investigate the diagnostic value of intraoperative frozen pathology for pulmonary nodulesand its guiding significance in surgical resection.Method： A totalof 1O8 patients with pulmonary nodules who underwentsurgical treatmentintheFirstPeople's HospitalofFuzhouCity from January2O23 toJune 2024 were selected retrospectively.The diagnostic results of pulmonary nodulesand the evaluation results of risk lesions by intraoperative frozen pathology and routine pathology were recorded，andthe valueof intraoperativefrozen pathology in guiding surgicalresection was evaluated.Result： The results of routine pathological examination were taken as the goldstandard.Theaccuracyrate of intraoperative frozen pathology in diagnosingatypical 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 ofhigh-risk lesions was 98.59% （7O/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 thepatientswith pulmonary lobectomycombined with lymphnode dissection，37casesof high-risk lesions and1case of low-risk lesion werediagnosedbyintraoperativefrozenpathology，34cases of high-risklesionsand 3 cases of low-risk lesions wereconfirmed by routine pathology.Among the patients with pulmonary segmentectomy/ wedge resection，7O cases of low-risk lesions were diagnosed by intraoperative frozen pathology，70 casesof lowrisk lesionsand1caseof low-risk lesions were confirmedby routinepathology.Conclusion：Theaccuracyrateof intraoperative frozenpathologydiagnosisof invasiveadenocarcinoma isrelativelyhigh，and ithas certainclinical significance for guiding the surgical resection range.

肺癌是全球范圍內(nèi)發(fā)病率和死亡率較高的惡性腫瘤，隨著醫(yī)學(xué)影像技術(shù)的進(jìn)步，尤其是低劑量螺旋CT和高分辨率CT的廣泛應(yīng)用，肺結(jié)節(jié)的檢出率顯著提高，這使得早期發(fā)現(xiàn)肺癌成為可能[1-2]。（剩余6080字）