乳腺针吸细胞学检查在乳腺肿瘤诊断中的应用价值  

Clinical application value of fine needle aspiration cytology in diagnosing breast tumors

作　　者：郜红艺[1] 张江宇[1] 张佳立[1] 张安秦[2] 王颀[2] 

机构地区：[1]广东省妇幼保健院病理科,广州510010 [2]广东省妇幼保健院乳腺病防治中心,广州510010

出　　处：《中华乳腺病杂志（电子版）》2009年第2期10-13,共4页Chinese Journal of Breast Disease(Electronic Edition)

摘　　要：目的探讨乳腺针吸细胞学(FNAC)检查对乳腺肿瘤诊断的准确性及应用价值。方法对1193例乳腺疾病患者进行FNAC检查,按照FNAC诊断标准进行分级诊断;并将其中267例患者的组织病理学检查结果与FNAC检查结果进行对比分析。FNAC分级诊断结果与患者的年龄、肿瘤部位及大小之间的相关性分析采用χ2检验。结果1193例患者中,FNAC诊断:I级886例(74.3%);II级228例(19.1%);III级44例(3.6%);IV级35例(2.9%)。乳腺FNAC阳性检出率(III级+IV级)与患者的年龄、肿瘤部位及大小无显著相关性。FNAC检查对乳腺恶性肿瘤诊断的敏感性为92.9%(79/85),特异性为100%(182/182);阳性似然比趋向无穷大,阴性似然比为0.07,Youden指数为0.93;假阴性率为7.0%(6/85),无一例假阳性。结论乳腺FNAC诊断乳腺恶性肿瘤的准确性高,对临床诊断、治疗有一定指导意义。Objective To study the accuracy and clinical application value of fine needle aspiration cytology （FNAC） in diagnosing breast tumors. Methods FNAC was performed on 1193 cases with breast le- sions, and 267 of them were subjected to histopathology diagnosis as well. The FNAC and histopathologieal diagnosis results were compared and analyzed. The correlation between FNAC results and age of patients, original region and size of tumor was analyzed by ehi-square test. Results Of the 1193 fine needle aspiration samples, 886（74.3% ） were diagnosed as grade Ⅰ, 228（ 19.1% ）as Grade Ⅱ, 44（3.6% ）as Grade Ⅲ, and 35 （2.9%） as grade IV. FNAC positive proportion （Grade Ⅲ ＋ Grade Ⅳ） didn＇t correlate with the age of patients, origi- nal region and size of tumor. Among them, 267 cases were studied with histopathology as well. The sensitivity and the specificity of malignant tumor were 92.9% （79/85） and 100% （ 182/182）, respectively. The positive likelihood ratio was infinite, and the negative likelihood ratio was 0.07, the Youden index was 0.93, the false negative rate were 7.0% （6/85）, no false positive diagnosis was found. Conclusions FNAC has high accuracy in diagnosing breast tumors, and is of clinical significance in guiding diagnosis and treatment.

关 键 词：乳腺肿瘤 活组织检查 针吸 

分 类 号：R737.9[医药卫生—肿瘤]