乳管内窥镜在乳头溢液诊治中的临床应用(附1000例分析)  

Application of breast fiberoptic ductoscopy with abnormal nipple secretion(an analysis of 1000 cases)

作　　者：郗俊生[1] 沈玉琨[1] 

机构地区：[1]中国人民解放军第四五五医院普外科,上海200052

出　　处：《中国癌症杂志》2006年第12期1016-1018,共3页China Oncology

摘　　要：背景与目的:乳头溢液是乳腺科门诊常见的症状,而临床上大约有1%的乳腺癌是乳头溢液为首发症状,大量临床摸不到的肿块的乳头溢液患者进行筛检可以早起发现乳腺癌,1997年国内发展新科技-乳腺纤维导管内视镜,用一根外径0.7 mm光导镜,自乳头溢液管口插入,用过内视镜成像技术观察并记录乳腺导管内正常及异常病变情况,优势在于不仅诊断敏感性较高(>90%),而且还行准确定位,用于早期诊断乳腺导管内疾病及早期乳腺癌。本研究评估纤维导管内窥镜在无肿块的乳头溢液诊断及治疗的临床价值。方法:用纤维导管内窥镜对1 000例乳腺溢液患者进行检查和治疗。结果:本研究对1 000例无肿块乳头溢液患者检查发现早期乳腺癌33例(3.3%),乳头状瘤392例(39.2%),乳头状瘤病20例(2%),导管扩张伴慢性炎症480例(48%),正常导管75例(7.5%),活检吸取肿块8例,3例报告导管内癌,导管慢性炎药物冲洗220例(22%),手术患者453例。经病理证实与导管镜检查符合率90.7%。结论:乳管内窥镜可插入到5级乳腺导管,能早期发现乳腺癌,对部分导管慢性炎症可用药物冲洗治疗,乳管内窥镜定位、定性准确,乳管内窥镜对早期乳腺癌的诊断和治疗具有深远价值。Background and purpose： Nipple secretion is one of the frequent symptoms in mammary gland disease. Clinically, about 1% breast cancer patients demonstrate with nipple secretion as initial symptom. It could be used as a screening tool for the patients with nipple secretion but no palpated mass and inerease the possibility of early diagnosis for breast cancer. In 1997, our country developed a new technique breast fiberoptic ductoscopy （ FDS）. It uses a q~ 0.7 millimeter optic scope to insert into the nipple discharge canal orifice, and depends on introscope technology to observe and record the normal or abnormal changes in manmlary gland ductus. Its advantages are not only in highly diagnostic sensitivity （ above 90%）, but also in accurate location of tumor, so it can be used to diagnose early breast cancer and mammary gland ductal diseases. This study evaluated the clinical effect of breast FDS in diagnosis and treatment of abnormal nipple secretion. Methods： 1 000 patients had been under examination by FDS. Results： Of the 1 000 cases, there were 33 cases （3.3%） of early breast cancer; 412 cases （41.2%） of papilloma and papillomatosis; and 480 cases （48%） of either ductal ectasia and or chronic inflammation. Duct endoscoptic biopsy was successfully performed on 30 cases, 220 cases （55%） with chromic inflammation were cured by perfusion. 453 cases were received operation . The accordanee rate with pathologic diagnosis was 90.7%. Conclusions： FDS is a very important and new method to diagnose breast. FDS could be inserted into 5th ducta lumen of breast and significantly increase the positive detection of breast cancer. Because the position and nature of the lesions can be determined accurately by FDS, tt is used as intervening treatment for some intraductal papilloma and chronic inflammatory disease. FDS will be of great influence on early diagnoses and treatment of the breast cancer.

关 键 词：乳头溢液 乳管内窥镜 

分 类 号：R737.9[医药卫生—肿瘤]