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| 微波消融改善甲状腺结节粗针穿刺活检的过程与结果 |
| 闫磊1,2△,章建全1△*,曹昆昆1,吴震中1,盛建国1,张航1 |
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(1. 第二军医大学长征医院超声诊疗科, 上海 200003;
2. 解放军100医院特诊科, 苏州 215007
△共同第一作者
*通信作者) |
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| 摘要: |
| 目的 探讨微波消融对甲状腺结节粗针穿刺活检标本质量、出血风险和病理结果的影响。方法 对251例甲状腺单发结节在微波消融前、消融后进行双重粗针穿刺活检，比较2次取材标本质量满意度、穿刺后甲状腺出血程度、病理切片可判读性及病理诊断结果的前后一致性。结果 甲状腺结节消融前、消融后组织学标本质量满意度分别为92.03%（231/251）、100%（251/251），消融后标本质量满意度较消融前提高（P=0.000）。消融前、消融后活检出血发生率分别为15.14%（38/251）、0%，消融后出血发生率较消融前降低（P=0.000）。251例甲状腺结节中良性结节184例，乳头状癌结节67例，除4例因微波消融前穿刺活检标本质量差而无法制片外，其余结节消融前和消融后粗针穿刺活检病理诊断总体一致性为100%。结论 微波消融术后即刻粗针穿刺活检不影响甲状腺结节病理诊断准确性，并且具有减少出血风险、改善标本质量的优点。 |
| 关键词: 甲状腺结节 病理诊断 粗针穿刺活组织检查 微波消融 微波消融术 手术中并发症 出血 |
| DOI：10.16781/j.0258-879x.2017.10.1250 |
| 投稿时间：2017-06-20修订日期：2017-09-25 |
| 基金项目:国家自然科学基金（81171436）. |
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| Microwave ablation improves the process and outcome of core needle biopsy in thyroid nodules |
| YAN Lei1,2△,ZHANG Jian-quan1△*,CAO Kun-kun1,WU Zhen-zhong1,SHENG Jian-guo1,ZHANG Hang1 |
(1. Department of Ultrasound, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China;
2. Department of Special Consultation, No. 100 Hospital of PLA, Suzhou 215007, Jiangsu, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To explore the effect of microwave ablation on the specimen quality, risk of bleeding and histopathological outcomes of core needle biopsy in thyroid nodules. Methods Core needle biopsy were performed on 251 cases of thyroid solitary nodules before and after microwave ablation, and then the specimen quality, hemorrhage of thyroid nodules after biopsy, legibility of pathological slices and the consistency of pathological diagnosis were compared. Results The specimen satisfaction rate of thyroid nodules after microwave ablation was significantly improved compared with that before microwave ablation (100%[251/251] vs 92.03%[231/251], P=0.000), and the incidence of bleeding after microwave ablation was significantly decreased versus that before microwave ablation (0% vs 15.14%[38/251]; P=0.000). And 184 of 251 thyroid nodules were benign and 67 were papillary thyroid carcinoma. In addition to 4 thyroid nodules which could not be sliced due to poor quality before microwave ablation, the overall consistency of pathological diagnosis in the remaining nodules before and after microwave ablation was 100%. Conclusion Core needle biopsy immediately after microwave ablation does not affect the diagnostic accuracy of thyroid nodules, and can reduce the risk of bleeding and improve the specimen quality. |
| Key words: thyroid nodule pathological diagnosis core needle biopsy microwave ablation microwave ablation intraoperative complications hemorrhage |
