伴乳头溢液乳腺癌的临床诊断研究  

Clinical diagnosis of breast cancer with nipple discharge

作　　者：朱彩霞[1] 王颀[1] 万舰[1] 张江宇[1] 张安秦[1] 

机构地区：[1]广东省妇幼保健院乳腺中心,广东广州510010

出　　处：《中华肿瘤防治杂志》2011年第15期1208-1210,1214,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：广东省科技计划项目(2010B060900060);广东省卫生厅项目(A2009086)

摘　　要：为了探讨≥30岁伴乳头溢液乳腺癌患者的临床诊断方法,回顾性研究163例(164个病灶)≥30岁单纯乳头溢液、乳头溢液合并肿块、乳头溢液合并局限性增厚乳腺癌患者的临床资料,分析患者乳腺X射线(MG)、超声(US)、乳管内视镜(MD)和MG联合US、MG联合MD的检查结果,进行统计学分析。单纯性乳头溢液乳腺癌MG、US和MD的阳性率分别是32.9%、16.5%和69.6%,合并肿块乳腺癌的阳性率分别为48.2%、42.9%和83.9%,合并局限性增厚乳腺癌的阳性率分别为82.8%、37.9%和79.3%。MG联合US在本研究各亚组中的阳性率和MG单独检查相比有提高,但差异无统计学意义(P>0.05),MG联合MD在合并腺体局限性增厚乳腺癌组中的阳性率和MG单独检查相比有提高,差异无统计学意义(P=0.23),但在其他两个亚组中差异有统计学意义,P=0.000。初步研究结果提示,单纯乳头溢液或乳头溢液合并肿块的患者诊断时行MG联合MD检查,可补充US检查,而乳头溢液合并局限性增厚患者行MG检查,可补充MD和US检查。The objective of this study was to evaluate the clinical diagnosis of 163 cases of breast cancer with nipple discharge at age no younger than 30 years-old. We performed a retrospective analysis of all patients presenting with only nipple discharge or with nipple discharge and dominant mass or with nipple discharge and asymmetric thick- ening. Parameters evaluated included patient mammographic, ultrasonographic, mammary ductoscopic findings and other combined assessment. For the patients with only nipple discharge, the positive rate of MG,US and MD was 32.9%, 16.5% and 69.6% respectively. For the patients with nipple discharge and dominant mass,it was 48.2%, 42.9% and 83.9% respectively. For the patients with nipple discharge and Asymmetric thickening, it was 82.8%, 37.9% and 79.3% respectively. There was no significant difference in MG alone and MG-US combination （P〉0.05） in all groups. There was statistically significant difference in MG alone and MG-MD combination at the groups of the patients with only nipple discharge and with nipple discharge and dominant mass（P=0. 000）, but there was no signif- icant difference in MG alone and MG-MD combination at the group of the patients with nipple discharge and Asym- metric thickening（P=0.23）. In conclusion, it implies that for the patients at age no younger than 30 years-old MG- MD combination can be considered valuable, and US can be considered supplementary method in the diagnosis of only nipple discharge or with dominant mass disease; MG alone can be considered valuable and MD and US can be considered supplementary method in the diagnosis of nipple discharge and Asymmetric thickening.

关 键 词：乳腺肿瘤/诊断 乳头溢液 乳管内视镜 

分 类 号：R737.9[医药卫生—肿瘤]