术中冰冻指导肺结节手术治疗现状及研究进展

Current Status and Research Progress of Intraoperative Frozen Section in Guiding Surgical Treatment of Pulmonary Nodules

摘要: 目的：总结术中冰冻切片病理检查(FS)在肺结节手术治疗中的应用价值及最新研究进展。方法：通过分析近年来国内外相关文献，对术中冰冻在肺结节良恶性判断、肺腺癌浸润程度评估以及手术方式选择等方面的优势、发展历程、局限性及未来方向进行综述。结果：术中冰冻具有诊断快速、实时性强、并发症少等优势，其诊断结果与术后石蜡病理具有较高的一致性，在早期肺腺癌的术式选择(亚肺叶切除与肺叶切除)中起到了关键的指导作用。然而，其在识别高危病理亚型(如微乳头型、实性型)方面仍存在一定局限性。结论：术中冰冻是肺结节精准外科治疗的重要工具。未来通过结合影像学、分子病理学及人工智能技术，有望进一步克服其局限性，实现更个体化的手术治疗。

Abstract: Objective: To summarize the application value and latest research progress of intraoperative frozen section (FS) in the surgical treatment of pulmonary nodules. Methods: By analyzing relevant domestic and international literature in recent years, this paper reviewed the advantages, development history, limitations, and future directions of intraoperative frozen section in determining the benign or malignant nature of pulmonary nodules, assessing the invasion degree of lung adenocarcinoma, and guiding surgical modalities. Results: Intraoperative frozen section boasts advantages such as rapid diagnosis, real-time capability, and fewer complications. Its diagnostic results show high consistency with final paraffin pathology and play a pivotal role in selecting surgical approaches (sublobar resection vs. lobectomy) for early-stage lung adenocarcinoma. However, limitations still exist in identifying high-risk pathological subtypes (e.g., micropapillary, solid patterns). Conclusion: Intraoperative frozen section is a vital tool for the precise surgical treatment of pulmonary nodules. Future integration with imaging, molecular pathology, and artificial intelligence is expected to overcome current limitations and achieve more individualized surgical treatment.