中央型与外周型乳腺导管内乳头状瘤的临床病理特点比较  

Comparison of the characteristics of central papillomas and peripheral papillomas

作　　者：高进[1] 唐炜[1] 叶熹罡[1] 陈伦[1] 谭维格[1] 潘凌霄[1] 张晓申[1] 郑文博[1] 

机构地区：[1]广州医科大学附属第一医院乳腺外科,510120

出　　处：《中华普通外科学文献（电子版）》2017年第3期168-171,共4页Chinese Archives of General Surgery(Electronic Edition)

基　　金：国家自然科学基金资助项目(81402203);广州市医药卫生科技项目(20151A011074)

摘　　要：目的探讨并比较中央型乳腺导管内乳头状瘤(IP)与外周型导管内乳头状瘤(IPS)的临床病理特点和预后。方法回顾性分析2004年1月至2013年12月广州医科大学附属第一医院收治的119例乳腺导管内乳头状瘤患者的临床资料,其中IP患者76例,IPS患者43例。对入组患者随访1~7年。结果全部入组患者均为女性,高发年龄段为30~49岁。与IP患者不典型增生率(11.8%)相比,IPS患者的发生率(41.9%)较高,差异有统计学意义(X^2=14.108,P=0.000),且癌变性也较高(X^2=8.602,P=0.003)。在临床表现为肿块的乳头状瘤患者中超声的诊断敏感度显著高于X线钼靶片(X^2=66.234,P<0.01)。对临床表现为乳头溢液的患者,纤维乳管镜检查有很高的准确性(84.1%),并且对于IP患者的检查准确性高于IPS患者(X^2=7.729,P=0.005)。IP与IPS均具有一定的复发率,并且IPS有更高的复发率(X^2=6.426,P=0.011)。结论与IP相比,IPS更容易合并不典型增生以及癌变;对于临床表现为肿块的乳头状瘤,超声检查优于钼靶片检查。IPS更容易复发,需要更加密切的临床随访。Objective To investigate and compare the characteristics and prognosis of intraductal papilloma （IP） and intraductal papillomatosis （IPS）.Methods The clinical data of one hundred and nineteen cases diagnosed as IP and IPS by pathology were collected and analyzed retrospectively, with 76 IP patients and 43 IPS patients. They were followed up for 1 to 7 years.Results All patients were female, aged from 12 to 79 years old, with a median age of 45 years old. Both of the two diseases mainly distributed from 30 to 49 years old. Compared with IP, IPS patients were more likely to have atypical hyperplasia （11.8%vs 41.9%） , with significant difference （χ2=14.108,P=0.000）, and malignant component （χ2=8.602,P =0.003）. Ultrasonography was more sensitive than mammography when the two types of diseases showed as mass （χ2=66.234,P〈0.01）. The accuracy rate of fiberoptic ductoscopy in the patients with nipple discharge was very high （84.1%）, especially in IPS patients （χ2=7.729,P=0.005）. Both of the two types diseases may recur, with higher percentage in IPS （χ2=6.426,P=0.011）. Conclusions Atypical hyperplasia and malignant tumour are more likely observed in IPS patients. Ultrasound is more sensitive than mammography when the two diseases showed as mass. Peripheral papillomas is more inclined to recur and needs more attention.

关 键 词：乳头状瘤 增生 复发 超声检查 

分 类 号：R737.9[医药卫生—肿瘤]