乳管镜检查中乳管内灌洗细胞学检查对乳腺溢液的临床价值  

Clinical value of lavage cytology to nipple discharge in laticifers endoscopy

作　　者：米黑热古丽.艾尼瓦尔 地力木拉提.艾斯木吐拉 克丽别娜.吐尔逊 

机构地区：[1]新疆医科大学第一附属医院乳腺外科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2013年第8期1118-1120,1124,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2011211A084)

摘　　要：目的评价乳管镜检查中乳管内灌洗细胞学检查对乳头溢液的诊断价值。方法选择2010年6-9月79例乳管镜诊断导管内隆起性病变,对病变导管进行手术、病理组织检查。并且分别在乳管镜检查前取乳头溢液涂片和乳管镜检查中对溢液导管用盐水灌洗,取灌洗液涂片行脱落细胞学检查的临床资料进行对比分析。结果79例乳管镜诊断导管内隆起性病变经手术病理组织检查证实：导管增生性病变66例（导管上皮增生25例,非典型增生1例,导管内乳头状瘤40例）,乳腺导管扩张炎症13例。脱落细胞学检查结果：常规细胞学检查导管内增生性病变主要表现为吞噬细胞和淋巴细胞（28%~40%）。灌洗液细胞学检查结果：导管内乳头状瘤主要表现为导管上皮细胞（50%）和增生的导管上皮细胞（30%）。导管普通型增生为导管上皮细胞（48%）,非典型增生为增生性上皮细胞,2种细胞学检查导管内增生性病变差异有统计学意义（P〈0.05）。导管扩张、炎性常规细胞学检查为淋巴细胞（46.15%）和吞噬细胞（30.77%）,灌洗液细胞学检查为吞噬细胞（38.46%）和炎性细胞（23.08%）,2种细胞学检查结果差异无统计学意义（P〉0.05）。常规细胞学的阳性预测值为88.89%,阴性预测值为18.03%,灵敏度为24.24%,特异度为84.62%;灌洗细胞学阳性预测值为94.83%,阴性预测值为47.62%,灵敏度为83.33%,特异度为76.92%,2种方法差异有统计学意义（P〈0.05）。结论常规细胞学和灌洗细胞学涂片、脱落细胞学检查与病理组织学检查结果相比,灌洗液细胞学诊断符合率明显高于常规细胞学。Objective To evaluate the diagnostic value of lavage cytology to nipple discharge in laticifers endoscopy.Methods 79patients were diagnosed with introductal apophysis lesions by laticifers endoscopy from Jun to Sep 2010and the diseased tubes underwent surgical treatment and postoperative pathological examination.Nipple discharge was collected,and then exfoliocytology examination was conducted before laticifers endoscopy examination.And the diseased tubes were lavaged with natural soil water,then lavage was collected and exfoliocytology examination was also conducted respectively.Finally,the two cytological examination results were compared and analyzed.Results Under the postoperative pathological examination,66cases of intraductal proliferative lesion were confirmed,including 25cases of ductal epithelial hyperplasia,1case of atypical hyperplasia,40cases of papillomatosis,and 13cases of laticifers expansion and inflammation were detected.The results of exfoliocytology examination were demonstrated as followed：The main distribution of cells with intraductal proliferative lesions were phagocytic cells and lymphocyte（28%~40%）in conventional cytology.Dutal epithelial hyperplasia（50%）and proliferative ductal epithlial cells（30%）were the main cells with papillomatosis in lavage cytology.Ductal epithelial hyperplasia（48%）was the main cell with intraductal typical hyperplasia and the proliferative ductal epithelial cell was the main cell with intraductal atypical hyperplasia.There were statistically significant differences between conventional cytology and lavagy cytology with the intraductal proliferative lesions（P ＆lt;0.05）.As to the laticifers expansion and inflammation,the majority cells were lymphocyte（46.15%）and phagocyte（30.77%）in conventional cytology and those were phagocyte（38.46%）and inflammation cell（23.08%） in lavage cytology.And there were not significant differences between the two examinations（P＆gt;0.05）.In the conventional cytology,the positive predictive valu

关 键 词：乳头溢液 乳管镜 细胞学 

分 类 号：R655.8[医药卫生—外科学]