超声引导下穿刺活检术与术中快速冰冻组织活检病理诊断乳腺肿块的临床应用比较  

Clinical application effect comparison of ultrasound-guided biopsy and intraoperative frozen tissue biopsy in pathological diagnosis of breast masses

作　　者：王小洁[1] 张里援[2] 陈湘宜 季丽丽[4] WANG Xiao-jie;ZHANG Li-yuan;CHEN Xiang-yi;JI Li-li(Department of Ultrasound,Wenzhou Hospital of Traditional Chinese Medicine,Wenzhou,Zhejiang 325000,China;不详)

机构地区：[1]温州市中医院超声科,浙江温州325000 [2]温州市中医院骨伤科 [3]温州市中医院中医妇科 [4]温州医科大学附属第一医院医学检验中心,浙江温州325000

出　　处：《中华全科医学》2020年第3期457-459,共3页Chinese Journal of General Practice

基　　金：国家卫生计生委重大疾病预防科技行动计划项目(ZX-01-C2016036)。

摘　　要：目的观察超声引导下穿刺活检术与术中快速冰冻组织活检对于乳腺肿块性状诊断的准确性。方法以自2018年6月-2019年6月于温州市中医院就诊并接受手术治疗的138例乳腺肿块患者为研究对象,分别对所有研究对象进行超声引导下穿刺活检和术中快速冰冻组织活检,以术后石蜡病理学检查结果为金标准,比较超声引导下穿刺活检术与术中快速冰冻组织活检对乳腺肿块性状诊断效果差异情况。结果 138例乳腺肿块患者经术后石蜡病理学检查,确诊恶性肿瘤62例(44.93%),良性肿瘤53例(38.41%),非肿瘤病变者23例(16.67%)。术中快速冰冻组织活检诊断特异性(96.05%)与超声引导下穿刺活检术水平(90.79%)差异无统计学意义(χ~2=1.713,P=0.191),而术中快速冰冻组织活检诊断灵敏度(93.55%)和准确度(94.93%)均显著高于超声引导下穿刺活检术水平(80.64%和86.23%),且差异均具有统计学意义(χ~2=4.593、6.114;P=0.032,0.013)。结论较超声引导下穿刺活检术,术中快速冰冻组织活检在降低乳腺恶性肿瘤漏检率和提高乳腺肿块性状诊断准确性方面更具优势,值得临床推广使用。Objective To observe the accuracy of ultrasound-guided biopsy and intraoperative frozen tissue biopsy in the diagnosis of breast masses. Methods A total of 138 patients with breast masses admitted in our hospital from June 2018 to June 2019 were enrolled in the study. Ultrasound-guided needle biopsy and intraoperative rapid frozen biopsy were performed on all subjects. The paraffin pathological examination results were used as the gold standard to compare the difference between ultrasound-guided biopsy and intraoperative frozen tissue biopsy in the diagnosis of breast masses. Results Sixty-two cases(44.93%) were diagnosed as malignant tumor, 53 cases(38.41%) as benign tumor and 23 cases(16.67%) as non-tumor. There was no significant difference between the diagnostic specificity of intraoperative frozen tissue biopsy(96.05%) and ultrasound-guided biopsy(90.79%, χ~2=1.713, P=0.191), while the diagnostic sensitivity(93.55%) and accuracy(94.93%) of frozen tissue biopsy were significantly higher than those of ultrasound-guided biopsy(80.64% and 86.23%, χ~2=4.593, 6.114;P=0.032, 0.013). Conclusion Compared with ultrasound-guided biopsy, intraoperative frozen tissue biopsy has more advantages in reducing the missed detection rate of breast malignant tumors and improving the diagnostic accuracy of breast mass characteristics, which is worthy of clinical application.

关 键 词：超声引导下穿刺活检术 术中快速冰冻组织活检 术后石蜡切片检查 乳腺肿块 诊断效果 

分 类 号：R446.8[医药卫生—诊断学] R730.4[医药卫生—临床医学]