乳腺钼靶X线三维立体定位系统引导下导丝定位活检的临床应用  

Clinical efficacy of mammograpy three- dimensional positioning system- guided wire- localized surgical biopsies for nonpalpable breast lesions

作　　者：冯宇[1] 赵霞[1] 张建梅[1] 吕淑贞[1] 穆颖[1] 王丹丹[1] 吕大鹏[1] 郭怡晖[1] 李艳萍[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院乳腺科,北京100038

出　　处：《中华普通外科学文献（电子版）》2016年第3期192-194,共3页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的：探讨乳腺钼靶X线三维立体定位系统引导下导丝定位手术活检在临床不能触及肿块的乳腺病变中的价值及可行性。方法回顾性研究2013年4月至2015年10月间收治的乳腺钼靶X线异常女性患者67例，对临床不能触及的乳腺病灶行导丝定位手术活检及病理检查。结果67例病灶均一次定位成功，发现乳腺癌17例（25.4%），癌前病变（导管上皮非典型增生及导管内乳头状瘤）13例（19.4%），其他良性病变37例（55.2％）。影像表现为微钙化灶的46例病例中乳腺恶性病变共16例（34.8％），癌前病变8例（17.4％），其他良性病变22例（47.8％）；非钙化组的21例病例中良性病变20例（95.2％），恶性病变1例（4.8％）。与影像表现为非钙化组比较，对于临床不能触及的乳腺病灶，乳腺钼靶X线影像表现为微钙化时乳腺癌检出率更高（χ2=5.369，P=0.021）。结论钼靶X线三维立体定位系统引导下导丝定位活检可以发现容易漏诊的早期乳腺癌及癌前病变，该方法简便、准确，值得推广。Objective To investigate the value and feasibility of wire-location surgical biopsies by mammograpy three- dimensional positioning system for non- palpable breast lesions. Methods Between April 2013 and October 2015, sixty-seven women with non-palpable breast lesions underwent surgery at Beijing Shijitan Hospital. Wire localization guided by mammograpy three- dimensional positioning system was performed before operation. Results All lesions founded out by mammograpy were accurately localized and excised. Seventeen cases （25.4%） were malignant, 13 （19.4%） were precancerous lesions （including ductal atypical hyperplasia and intraductal papilloma）, and cases 37 （55.2%） were benign lesions by pathologic diagnosis. 34.8% （16/46） cases with microcalcifications were malignant, 17.4% （8/46） were precancerous lesions, and 47.8% （22/46） were benign lesions. In non-calcification group, 95.2% （20/21） were benign lesions and 4.8% （1/21） were malignant. By statistical analysis, the detection rate of breast cancer was higher in the cases with microcalcifications （χ2=5.369, P=0.021）. Conclusion Careful consideration should be taken for the cases of non-palpable breast lesions, and mammograpy three-dimensional positioning system-guided wire localization of breast lesions is useful in assisting surgical biopsy and worth extensive generalization.

关 键 词：乳腺肿瘤 X线疗法 活组织检查 针吸 

分 类 号：R737.9[医药卫生—肿瘤]