新疆3154例乳腺乳头溢液与导管内病变关系的临床分析  

Clinical correlation of intra-ductal lesion and breast nipple discharge in Xinjiang area： a study based on 3154 cases

作　　者：地力木拉提·艾斯木吐拉[1] 栾梅香[1] 王永高[1] 樊珈榕[1] 杨纾旖[1] 阿迪力[1] 

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：《中华普通外科杂志》2013年第9期679-681,共3页Chinese Journal of General Surgery

摘　　要：目的 探讨新疆地区汉族、维吾尔族、哈萨克族及其他民族的妇女乳腺乳头溢液与乳腺导管内病变的关系.方法 收集2004-2010年3154例经病理组织证实,纤维乳管镜检查、手术治疗的导管内病变患者临床资料并进行统计分析.结果 3154例导管内病变包括导管内上皮普通型增生（usual ductal hyperplasia,UDH） 335例（10.62％）,导管上皮非典型增生（atypical ductal hyperplasia,ADH）312例（9.89％）,导管原位癌（ductal carcinoma in situ,DCIS）57例（1.81％）、导管内乳头状瘤（intraductal papilloma,IDP） 2223例（70.48％）、浸润性导管癌（infiltrating ductal carcinoma,IDC） 227例（7.20％）.发病年龄在30 ～50岁占71.99％,各民族之间差异无统计学意义（P＞0.05）.导管内病变ADH汉族多见（11.42％）,UDH维吾尔族多见（19.73％）,IDC哈萨克族多见（15.74％）（均P ＜0.05）；IDP和DCIS的发病率在各民族之间差异无统计学意义（P＞0.05）；溢液性质与导管内病变关系比较结果：UDH、ADH、DCIS及IDP以浆液性溢液为主,分别为64.78％（217/335）,59.94％（187/312）,45.61％ （26/57）,46.92％ （1043/2223）,血性溢液主要见于IDC、DCIS,分别为84.14％（191/227）、42.11％（24/57）（均P＜0.05）.结论 乳头溢液可能是导管内病变的早期表现,不同民族导管内不同病变构成比有差异.Objective To explore the relationship between intra-ductal lesion and breast nipple discharge in Han, Uyghur and Kazakh ethnic patients in Xinjiang Uygur Autonomous Region. Methods Fiberoptic ductoscopy and surgery were performed in 3154 pathologically confirmed intra-ductal lesion patients and clinical data were retrospectively analyzed. Results Of 3154 patients with intraductal lesions, 335 were usual ductal hyperplasia （UDH, 10. 62% ） , 312 were atypical ducta] hyperplasia （ADH, 9. 87% ）, 57 were ductal carcinoma in situ （DCIS, 1.81% ）, 2223 were intraductal papilloma （IDP, 77.91% ） , and 227 were infiltrating ductal carcinoma （ IDC, 7.20% ）. In 71.99% of reported cases, ages ranged from 30 to 50 years with no statistical significance between different ethnic groups （ P 〉 0. 05 ）. ADH was mostly seen in Han patients （ 11.42% ）, UDH in Uygur patients （ 19. 73% ） , and IDC in Kazakh patients （15.74%） （P 〈 0. 05 ）. However, there was no significant differences shown for IDP and DCIS between different ethnic groups （P 〉 0. 05）. The serous discharge was mainly seen in UDH （64. 78% , 217/335）, ADH （59. 94% , 187/312）, DCIS （45.61% , 26/57） , and IDP （46. 92% , 1043/2223 ）. However, bloody discharge was mainly seen in IDC （ 84. 14% , 191/227 ） , and DCIS （42. 11% , 24/57 ） with statistically significant differences （ P 〈 0. 05 ）. Conclusions Breast nipple discharge could be an early manifestation of intra-ductal lesions, and spectrum of intra-ductal lesions differs in different ethnic groups.

关 键 词：乳腺疾病 内窥镜检查 乳头溢液 导管内病变 

分 类 号：R737.9[医药卫生—肿瘤]