小细胞型乳腺癌细针吸取细胞学诊断探讨  

Diagnosis of small cell breast cancer by fine needle aspiration cytology

作　　者：付春林 李军川 陈庭煊 夏波 任红兵 段六生 凌象红 

机构地区：[1]荆州市肿瘤医院病理科,湖北荆州434000

出　　处：《现代肿瘤医学》2010年第11期2152-2156,共5页Journal of Modern Oncology

摘　　要：目的:探讨小细胞型乳腺癌细针吸取细胞学诊断要点及鉴别诊断。方法:分析26例小细胞型乳腺癌临床、细针穿刺和细胞学特点,同时与64例乳腺增生症、82例乳腺纤维腺瘤对照。结果:26例小细胞型乳腺癌:≥40岁、穿刺针感脆样或偏软均占88.5%(23/26),穿刺容易吸出物质占80.8%(21/26),以散在或小细胞群为主、圆形细胞核占绝大多数、核间疏松排列均占76.9%(20/26),排列杂乱、无极性占84.6%(22/26),腺腔样、腺管样、爆竹样、栅栏样排列分别为61.5%(16/26)、34.6%(9/26)、19.2%(5/26)、30.8%(8/26),散在细胞中等量以上、圆形核占绝大多数均占84.6%(22/26),胞浆完整88.5%(23/26),未见肌上皮细胞92.3%(24/26),均明显高于乳腺增生症、乳腺纤维腺瘤的相对病例数,差异有统计学意义,均P<0.01;细胞数量多的占69.2%(18/26),明显高于乳腺增生症4.7%(3/64),P<0.01;黏液变的纤维间质成分及其与乳腺上皮细胞混杂均0例,明显低于乳腺纤维腺瘤的98.6%(80/82)、75.6%(62/82),均P<0.01。结论:细胞量较多,以小细胞群或散在细胞为主,细胞排列松散、紊乱无极性,易见腺腔、腺管、爆竹、栅栏等特殊排列,胞浆完整、核圆形,散在细胞较易见,肌上皮细胞不见,≥40岁,穿刺针感脆样或偏软、容易吸出物质等是小细胞型乳腺癌细针吸取细胞学诊断要点,与乳腺增生症、乳腺纤维腺瘤可以鉴别。Objective：To investigate the diagnostic value of fine needle aspiration cytology（FNAC） on patients with small cell breast carcinoma and to make differential diagnosis from breast hyperplasia and breast fibroadenoma.Methods：To analyze the clinical manifestations,the characteristics of fine needle aspiration and cytological features about 26 cases of small cell type of breast cancer,and contrast with 64 cases of breast hyperplasia and 82 cases of fibroadenoma.Results：In 26 cases of small cell type breast cancer,88.5%（23/26） were ≥40 year old or needle flu was crisp of soft,80.8%（21/26）were easier to suck out the material,76.9%（20/26） were with small groups or scattered cells in the main or round nuclei in most main or loose distance between the nuclear,84.6%（22/26） at arrangement was messy and nonpolar,the cases can be observed as gland cavity,duct,firecrackers,fence of arrangement were 61.5%（16/26）,34.6%（9/26）,19.2%（5/26） and 30.8%（8/26）,the rate of moderate or more scattered cells,most of the nuclei were round,cytoplasmic integrity were 84.6%（22/26）,84.6%（22/26）and 88.5%（23/26）,92.3%（24/26） of cases were not found myoepithelial cells.All above features were significantly higher than breast hyperplasia and fibroadenoma（P0.01）.69.2%（18/26）were large amounts of cells,it was significantly higher than 4.7%（3/64） of hyperplasia（P0.01）,zero was mucus change interstitial fiber components and its relationship with mammary epithelial cells mixed,it was significantly lower than 98.6%（80/82）,75.6%（62/82）of fibroadenoma（P0.01）.Conclusion： More cells,with small groups or scattered cells,cells were loosely packed,disordered and nonpolar,as the gland cavity or duct or firecrackers or fence of arrangement can be clearly observed,cytoplasmic integrity,nuclear round,scattered cells easier to be observed,no myoepithelial cell,≥40 year old,crisp of soft needle feeling,easy to suck out the material are the diagnostic points of small cell type o

关 键 词：小细胞型乳腺癌 细针吸取细胞学 诊断 

分 类 号：R737.9[医药卫生—肿瘤]