乳管镜与乳管造影在诊断未扪及肿块乳头溢液性疾病中的对比研究  

A comparative study of fiberoptic ductoscopy versus galactography in diagnosis of nipple discharge without palpable mass

作　　者：付明刚[1] 梁挺[1] 刘莎[1] 郭丽英[1] 

机构地区：[1]新疆医科大学第一附属医院乳腺外科,乌鲁木齐市830054

出　　处：《广西医学》2015年第6期765-766,776,共3页Guangxi Medical Journal

基　　金：新疆重大疾病医学重点实验室项目(SKLIB-XJMDR-ZX-2014-1)

摘　　要：目的对比乳管镜与乳管造影在诊断未扪及肿块的乳头溢液性疾病中的效果。方法对42例未扪及肿块的乳头溢液患者分别行乳管镜及乳管造影检查,以手术后病理诊断为"金标准",对比乳管镜和乳管造影对乳头溢液性疾病诊断效果。结果乳管镜与乳管造影均能够获得清晰图像。术后病理诊断为占位性病变38例,包括乳管内乳头状瘤27例,乳管内乳头状瘤病9例,导管内癌2例;非占位性病变4例,为乳腺导管扩张性疾病。乳管镜对未扪及肿块的乳头溢液性疾病的诊断符合率为92.86%,灵敏度为94.59%,特异度为80.00%,阴性预测值为66.67%,阳性预测值为97.22%,均明显高于乳管造影的80.95%、88.24%、50.00%、50.00%、88.24%。结论乳管镜可作为未扪及肿块的乳头溢液患者的首选诊断方法,乳管镜结合乳腺导管造影检查可减少误诊及漏诊。Objective To compare the effects of fiberoptic ductoscopy versus galactography applied to the diagnosis of nipple discharge without palpable mass.Methods Forty-two nipple discharge patients without palpable mass accepted fiberoptic ductoscopy and galactography, respectively.Taking the postoperative pathological results as the golden standard,the effects of fiberoptic ductoscopy and galactography applied to the diagnosis of nipple discharge were compared.Results Fiberoptic ductoscopy and galactography were successfully imaged.The postoperative pathological result showed that there were 38 cases of space-occupying lesion which included 27 cases of intraductal papilloma,9 cases of intraductal papillomatosis and 2 cases of ductal carcinoma in situ,and 4 cases of non-space-occupying lesion which were mammary ductal ectasia.The diagnostic coincidence rate of fiberoptic ductoscopy for nipple discharge without palpable mass was 92.86%.The sensitivity, specificity,negative predictive value and positive predictive value of fiberoptic ductoscopy were significantly higher than those of galactography （94.59% vs.80.95%,80.00% vs.88.24%,66.67% vs.50.00% and 97.22% vs.88.24%,respectively,P 〈0.05）.Conclusion Fiberoptic ductoscopy could be the first choice for the diagnosis of nipple discharge without palpable mass.Fiberoptic ductoscopy combined with galactography might contribute to reducing misdiagnosis and missed diagnosis.

关 键 词：乳头溢液 乳管镜 乳腺导管造影 乳头状瘤 诊断 

分 类 号：R655.8[医药卫生—外科学]