X线立体定位真空辅助活组织检查对乳腺微小钙化灶的诊断价值  

Diagnostic value of X-ray stereotactic vacuum-assisted biopsy for breast micro-calcification

作　　者：徐晓洲[1] 宋颖[2] 张柏林[1] 赵燕凤[2] 李静[2] 杨迅[1] 王翔[1] 

机构地区：[1]中国医学科学院肿瘤医院乳腺外科,北京100021 [2]中国医学科学院肿瘤医院影像诊断科,北京100021

出　　处：《肿瘤研究与临床》2015年第4期243-245,共3页Cancer Research and Clinic

摘　　要：目的 探讨X线立体定位真空辅助活组织检查和金属丝引导开放手术活组织检查对乳腺微小钙化灶的诊断准确性及临床效果.方法 收集2010年1月至2014年6月期间接受X线立体定位乳腺微小钙化灶活组织检查的患者681例,其中X线立体定位乳腺微小钙化灶真空辅助活组织检查（SVAB） 78例,X线立体定位（金属丝引导）乳腺微小钙化灶开放手术活组织检查603例,所有病例均为临床触诊阴性乳腺病灶（NPBL）,BI-RADS分类4类.对两种方法的诊断准确性及临床效果进行对比评价.结果 X线立体定位真空辅助活组织检查和金属丝引导开放手术活组织检查的诊断敏感度均为100％,漏诊率均为0.X线立体定位真空辅助活组织检查存在低估诊断,发生率为12.5％,但在手术所致局部变形发生率及手术并发症等方面明显优于金属丝引导开放手术组,且避免了大量良性病灶的开放手术活组织检查,使77.5％的患者获益.结论 X线立体定位真空辅助活组织检查是一种准确、安全、便捷的活组织检查方法,可以推荐作为乳腺微小钙化灶（BI-RADS 4类）的首选活组织检查方法,但对于X线立体定位真空辅助活组织检查病理诊断为中度以上不典型增生及各类癌患者,应进一步行开放手术.Objective To compare the accuracy and clinical effect between X-ray stereotactic vacuum-assisted biopsy （SVAB） and metal wire guided lumpectony.Methods From January 2010 to June 2014,681 cases of breast micro-calcification biopsy were performed.Among them,78 cases were performed with SVAB and 603 eases were performed with the method of stereotaetic metal wire guided lumpectomy.All cases were non-palpable breast lesions （NPBLs） and breast imaging-reporting and data system （BI-RADS） assessment categories 4.The diagnostic accuracy and clinical effect were compared.Results The sensitivity of both methods was 100 ％ with no misdiagnosis.The underestimation rate of SVAB was 12.5 ％.Compared with the method of metal wire guided lumpectomy,SVAB had many advantages,such as easy to use,quickly performed,low rate of local deformation and lower rate of operative complications.77.5 ％ patients benefited from SVAB by avoiding open surgery of benign disease.Conclusions SVAB is an accurate,safe and convenient method of biopsy.It can be recommended as the preferred method of micro-calcification （BI-RADS 4）.Additional operation should be performed on patients with the pathological diagnosis of middle and high grade of dysplasia and any kind of carcinoma.

关 键 词：乳腺微小钙化灶 真空辅助活组织检查 诊断 金属丝引导手术 

分 类 号：R737.9[医药卫生—肿瘤]