The Guiding Significance Of Intraoperative Rapid Frozen Pathology In The Diagnosis And Treatment Of Pulmonary Nodules

Objective: The aim of this study is to explore the guiding significance of intraoperative rapid frozen pathology in the diagnosis and treatment of pulmonary nodules.Methods:The medical records of 301 patients with pulmonary nodules who underwent surgical treatment in the department of thoracic surgery of the Eastern Hospital of the Fourth Hospital of Hebei Medical University from May 2015 to January 2019 were collected.Patients with confirmed frozen pathology who were operated for wedge resection with multiple intrapulmonary metastases of lung cancer and frozen pathological data of lymph node were excluded.A total of 297 patients were enrolled.The relevant patients’ medical records were reviewed,and the intraoperative frozen pathological results and postoperative paraffin pathological results were obtained.The pathological results were compared,and the confirmed diagnosis,misdiagnosis and delayed diagnosis of frozen sections were analyzed.SPSS 21.0 software was used for data processing,and logistics regression analysis was used for multifactor analysis.P<0.05 was considered statistically significant.Results:There were 312 cases of rapid frozen pathology during operation and 312 cases of postoperative paraffin pathology returns.288 cases were diagnosed by frozen pathology,7 cases were misdiagnosed,and 17 cases were delayed.The diagnosis rate of frozen pathology was 92.31%,the misdiagnosis rate was 2.24%,and the delayed diagnosis rate was 5.45%.There were 7 cases of misdiagnosis,including 5 cases of false negative and 2 cases of false positive.There were 17 cases of delayed diagnosis,including 10 cases of malignant lesions,and 7 cases of benign lesions.Among the misdiagnosed cases and delayed diagnosed cases,there were 11 cases of early adenocarcinoma.The diagnostic accuracy of CT was 84.00%.Using logistics regression analysis,age is a correlation factor for the confirmed diagnosis of frozen pathology,OR=2.461(1.492,4.060).Age and density were related factors for the nature of pulmonary nodules(benign or malignant),with age OR=1.729(1.317,2.268),density OR=2.502(1.563,4.004).Age and density were related to lung adenocarcinoma,with age OR=1.473(1.136,1.910),density OR=2.791(1.781,4.375).Conclusion:For patients with pulmonary nodules who have difficulty in definitive pathology before surgery,rapid intraoperative frozen pathology is important for the choice of surgical methods.