摘要
目的:探讨甲状腺细针穿刺细胞蜡块技术对提高病理诊断准确性的意义。方法:随机选择河北省人民医院113例术前可疑且术后病理证实为甲状腺乳头状癌患者，手术前行细针穿刺后并进行了常规细胞学涂片和制作细胞蜡块。两种技术方法制作的涂片/切片进行满意度评价，评价两种方法的在病理诊断中的准确性。结果:细胞蜡块法制作切片细胞排列结构完整，细胞核和细胞质结构清晰，不受红细胞影响，不满意度为0.9%（1/113），常规涂片组不满意度为8.8%（10/113），差异有统计学意义（P<0.05）。甲状腺乳头状癌诊断正确率方面，细胞蜡块法阳性率（110/113，97.3%）比常规涂片法阳性率（100/113，88.5%）高，差异有统计学意义（P<0.05）。结论:对比甲状腺穿刺常规细胞涂片，细胞蜡块的满意度更高、诊断正确率更高；此外细胞蜡块还可以做免疫组织化学染色，解决疑难诊断问题。
Abstract
Objective:To explore the value of cell block technique in thyroid fine needle aspiration to improve the accuracy of pathological diagnosis of thyroid diseases.Methods:One hundred and thirteen cases of papillary thyroid carcinoma from Hebei General Hospital were randomly selected, and routine cytological smears and cell embedding were performed after fine-needle aspiration. The diagnostic results were confirmed by postoperative pathological results.Results:There was a statistically significant difference in the degree of dissatisfaction between the cell block group (1/113, 0.9%) and the conventional smear group (10/113, 8.8%). In terms of the diagnostic accuracy for papillary thyroid carcinoma, the positive rate in the cell block group (110/113, 97.3%) was significantly higher than that of the conventional smear group (100/113, 88.5%; P<0.05).Conclusion:Compared with conventional cell smear, cell block technique has a higher degree of satisfaction and higher diagnostic accuracy. In addition, cell blocks can also be immunohistochemically stained to solve difficult diagnostic problems.
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