术前空芯针穿刺活检术对乳癌的诊断价值  

DIAGNOSTIC VALUE OF PREOPERATIVE CORE NEEDLE BIOPSY FOR BREAST CANCER

作　　者：陈淑如[1] 吴楚成[1] 柳镇玉[2] CHEN Shuru;WU Chucheng;LIU Zhenyu(Department of Breast Surgery,Huizhou Central People＇s Hospital,Huizhou 516001,China)

机构地区：[1]惠州市中心人民医院乳腺外科,广东惠州516001 [2]惠州市中心人民医院放疗科,广东惠州516001

出　　处：《青岛大学学报（医学版）》2018年第4期419-422,共4页Journal of Qingdao University(Medical Sciences)

基　　金：惠州市科技计划项目(2014Y036)

摘　　要：目的探讨术前空芯针穿刺活组织检查(CNB)对乳癌的诊断价值。方法选取我院确诊的乳癌病人842例,术前行CNB检查者402例(实验组),行开放式手术活组织检查(OSB)者440例(对照组)。比较两组病人诊断准确率,分析影响病人无瘤生存期(DFS)和总生存期(OS)的因素。结果实验组采用保乳术的百分率高于对照组(!2=22.36,P<0.05)。实验组阳性检出率为89.8%,CNB在不同T分期、N分期、是否伴有钙化病人中检出率差异有显著性(!2=3.36~14.63,P<0.05)。11例导管内癌伴微浸润病理低估为导管内癌,3例导管内癌伴浸润病理低估为非典型增生。乳癌病人DFS和OS的影响因素均为N分期、内分泌治疗或化疗(95%CI=1.65~8.25,P<0.05)。实验组局部复发与对照组比较差异无显著意义(!2=0.04,P>0.05)。结论 CNB诊断乳癌安全、特异性高,且不影响病人DFS和OS,是术前诊断乳癌的一种有效方法。Objective To explore the diagnostic value of preoperative core needle biopsy（CNB）for breast cancer.Methods A total of 842 patients diagnosed with breast cancer in our hospital were enrolled as subjects.In those patients,402（experimental group）received preoperative CNB and others（control group）received open surgical biopsy.The diagnostic accuracy was compared between the two groups.The factors influencing disease-free survival（DFS）and overall survival（OS）time were analyzed. Results The percentage of patients undergoing breast-conserving surgery was significantly higher in the experimental group than in the control group（χ~2=22.36,P〈0.05）.The positive rate was 89.8%in the experimental group.There were significant differences in the detection rate of CNB between patients with different T stages or N stages or with and without calcification（χ~2=3.36-14.63,P〈0.05）.Eleven patients with intraductal carcinoma and microinvasion were diagnosed with intraductal carcinoma alone,while three patients with intraductal carcinoma and invasion were misdiagnosed with atypical hyperplasia.The factors influencing DFS and OS in patients with breast cancer were N staging and endocrine therapy or chemotherapy（95%confidence interval=1.65-8.25,P〈0.05）.There was no significant difference in local recurrence between the experimental group and the control group（χ~2=0.04,P〉0.05）. Conclusion For the diagnosis of breast cancer,CNB is safe,highly specific,and without any effects on DFS and OS time.It is an effective method for the diagnosis of breast cancer.

关 键 词：乳房肿瘤 活组织检查 细针 诊断 鉴别 预后 

分 类 号：R737.9[医药卫生—肿瘤] R116.8[医药卫生—临床医学]