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目的探讨甲状腺癌术中冰冻切片误诊的诊断和治疗的对策。方法回顾性分析本院22例术中冰冻切片误诊的甲状腺癌患者的临床资料。结果再次手术13例,行患侧残余腺叶并峡部及对侧腺叶次全切除术10例,加全组淋巴结清扫术2例,患侧残余腺叶并峡部切除术3例。二次手术石蜡病理切片提示残余癌3例,1例残余腺体未见癌组织,肿大的淋巴结见癌组织,残癌率为30.77%。结论对于临床高度怀疑甲状腺癌而冰冻切片未能确诊的病例一期行患侧腺叶全切术或次全切除术是可行的,可以避免二次手术。
Objective To investigate the diagnosis and treatment of misdiagnosis of intraoperative frozen sections of thyroid cancer. Methods The clinical data of 22 patients with thyroid carcinoma misdiagnosed as frozen sections in our hospital were retrospectively analyzed. Results Reoperation in 13 cases, the residual ipsilateral lobes and isthmus and the contralateral lobectomy in 10 cases, plus the whole group of lymph node dissection in 2 cases, ipsilateral residual gland lobes and isthmus resection in 3 cases. Paraffin biopsy of secondary surgery suggested residual cancer in 3 cases, 1 case of residual gland without cancer, enlarged lymph nodes see cancer, the residual cancer rate was 30.77%. Conclusions For patients with highly suspected thyroid cancer but not frozen sections, one-stage total lobectomy or subtotal gastrectomy is feasible and can avoid secondary surgery.