纤维乳管内视镜对乳头血性溢液的诊断价值  

Fiberoptic ductoscopy for evaluation of bloody nipple discharge

作　　者：雷莹 李今 何建军[2] 

机构地区：[1]陕西省妇幼保健院乳腺外科,陕西西安710003 [2]西安交通大学第一附属医院乳腺外科,陕西西安710061

出　　处：《中华肿瘤防治杂志》2015年第24期1894-1897,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的 乳头血性溢液（bloody nipple discharge,BND）可为乳腺癌唯一或首发症状,其诊断方法有多种。本研究旨在探讨纤维乳管内视镜（fiberoptic ductoscopy,FDS）对BND的诊疗价值。方法 回顾性分析2003-09-01-2012-02-01陕西省妇幼保健院乳腺外科就诊的1 283例BND患者的临床资料以及FDS诊断资料,与手术后病理诊断结果对比,采用χ2检验法分别进行单因素分析,从中筛选对病变性质影响有统计学意义的临床因素作为自变量,并对这些变量运用逐步Logistic回归分析法进行多因素分析。结果 经与手术后病理诊断结果对比,FDS诊断符合率为97.35%（1 249/1 283）,其中误诊34例,占2.65%。单因素分析结果显示,年龄〉40岁、暗红色血性溢液或FDS诊断病变位于Ⅲ~Ⅳ级乳管是BND患者与乳腺癌相关的高危因素,P〈0.05;溢液的位置、孔数对病变性质的鉴别差异无统计学意义,P〉0.05。多因素分析结果显示,年龄〉40岁、暗红色血性溢液及FDS诊断病变位于Ⅲ~Ⅳ级乳管是乳头血性溢液患者与乳腺癌相关的高危因素,P〈0.05。结论 FDS可作为BND疾病的首选检查方法,患者年龄、溢液颜色及病变位于乳管内位置对鉴别导致乳头溢液病变的良、恶性具有重要临床意义。OBJECTIVE To determine the role of fiberoptic ductoscopy （FDS） in diagnosis and treatment of bloody nipple discharge（BND）. METHODS 1 283 cases with BND underwent FDS were retrospectively studied. RESULTS The FDS results were compared with pathological examination. The accordance rate of FDS diagnosis was 97. 35% （1 249/1 283）, 34 cases were misdiagnosed by FDS and the wrong diagnosis rate was 2. 65% 2. Univariate analysis showed that the risk factors for breast cancer usually increased in patients with BND accompanied by dark bloody discharge or location of intraductal lesions or those aged over 40 （P〈0.05）. The lesions in breast and the numble of bloody nipples were not correlated with the diagnoses of benign and malignant degrees of BND （P〈0.05）. 3. Multivariate analysis indicated that patients aged over 40 with BND accompanied by dark bloody discharge or lesions located in the Ⅲ-Ⅳ duct system had a higher risk of breast cancer （P〈0.05）. CONCLUSION FDS can be used as the preferred diagnostic method of BND, The ages of patients with BND accompanied by dark bloody discharge or lesions located in the duct sys tem may significantly affect the diagnosis of benign and malignant BND lesions.

关 键 词：纤维乳管内视镜 乳头血性溢液 诊断 回顾性分析 

分 类 号：R737.9[医药卫生—肿瘤]