乳腺导管内乳头状瘤663例临床及诊断特点  

Clinical and diagnostic characteristics of intraductal papilloma of breast in 663 cases

作　　者：韩晓蓉[1] 王颀[1] 连臻强[1] 张江宇[2] 韩旎[1] 何秋苑[3] 

机构地区：[1]广东省妇幼保健院乳腺科,广州511400 [2]广东省妇幼保健院病理科,广州511400 [3]广东省妇幼保健院病案科,广州511400

出　　处：《岭南现代临床外科》2013年第4期304-307,共4页Lingnan Modern Clinics in Surgery

基　　金：广东省医学科研基金(编号:A2008096)

摘　　要：目的总结乳腺导管内乳头状瘤(IP)的临床及诊断特点。方法回顾分析我院2008年1月至2010年12月期间收治的663例导管内乳头状瘤的临床资料。结果本组患者主要分布于30～50岁年龄段女性,以30～40岁最多,大多表现为乳头溢液,亦有10%左右表现为不可扪及肿块经B超检查微创活检发现。本组患者中乳腺超声有阳性发现者40.2%,乳腺X线检查有阳性发现者仅10%;纤维乳管镜检查的诊断符合率为95.7%,液基薄层细胞学检查(TCT)对IP的敏感性为74%,特异性为96.3%。本组患者平均随访13.3个月,有25例(4.5%)患者出现同侧复发,复发者均为多发乳头状瘤。结论乳腺导管内乳头状瘤多以乳头溢液为主要表现,超声检查有一定诊断价值;X线检查对IP的诊断缺乏特异性,可用于鉴别诊断;纤维乳管镜是诊断IP的首选方法,可辅以TCT检查以提高诊断率。多发乳头状瘤术后有一定复发率,应定期随访,如有复发应再次手术。Objective To investigate the clinical and diagnostic characteristics of intraductal papilloma of breast.Methods The clinical data of 663 patients with intraductal papilloma from Jan 2008 to Dec 2010 were analyzed retrospectively.Results The age of this group mainly distributed in 30-50 years old and nipple-discharge was the main clinical characteristic.Some cases were nonpalpable breast mass and were detected by ultrasonography and vacuum assisted biopsy.In this group,.there were about 40.2% patients who had positive results in ultrasonography and there were only about 10% patients who had a positive results in mammography.The diagnostic accordance rate of fibro-optic ductoscopy for IP was 98%.The sensitivity and specificity of thinprep cytology test（TCT） for IP were 74% and 96.3% respectively.The average follow-up time of this group was 13.3 months,there were 25 patients who had homolateral recurrence and all of these were multiple intraductal papilloma.Conclusions The main clinical characteristic of intraductal papilloma is nipple discharge and fibro-optic ductoscopy is a preferred diagnostic method for intraductal papilloma..TCT is helpful to increase the diagnostic accuracy.Multiple intraductal papilloma has recurrence rate of 4.5%,so the regular follow-up is necessary.

关 键 词：导管内乳头状瘤 超声检查 乳腺X线摄影术 纤维乳管镜 液基薄层细胞学检查 

分 类 号：R655.8[医药卫生—外科学]