乳腺乳头状病变穿刺与切除病理诊断对照研究  

Comparative study of pathological diagnosis between puncture and resection of breast papillary lesions

作　　者：孙新宇 SUN Xin-yu(Department of Pathology,Huarun Liaoning Health Industry Group Fuxin Mine General Hospital,Fuxin 123000,China)

机构地区：[1]华润辽宁健康产业集团阜新矿总医院病理科,123000

出　　处：《中国现代药物应用》2020年第24期26-28,共3页Chinese Journal of Modern Drug Application

摘　　要：目的探讨空心针穿刺活检(CNB)与切除病理诊断乳腺乳头状病变的价值。方法300例经CNB诊断为乳腺乳头状病变的患者,其中238例患者接受CNB后,行切除乳腺肿物手术,分析CNB与切除病理的诊断结果。结果手术切除病理诊断乳腺疾病9例,占比3.78%(9/238),均被CNB误诊,且没有发现肿瘤组织;CNB诊断导管内乳头状瘤(IP)96例,占比40.34%;非典型导管内乳头状瘤(AIP)74例,占比31.09%;乳头状癌(PC)68例,占比28.57%。CNB诊断IP、AIP、PC均有误诊与漏诊现象。CNB中,诊断IP结果与切除病理诊断结果吻合率为68.75%(66/96),诊断AIP结果与切除病理诊断吻合率为82.43%(61/74),诊断PC结果与切除病理诊断吻合率为100.00%(68/68);诊断IP时,有25例病变级别降低,占比26.04%(25/96);诊断AIP时,有6例病变级别降低,占比8.11%(6/74)。结论诊断乳腺乳头状病变时,选择CNB诊断法,可以收到较准的诊断结果,但有低估病情的现象,应当与切除病理诊断相结合,提高诊断准确度。Objective To discuss the value of core needle biopsy(CNB)and resection pathology in the diagnosis of breast papillary lesions.Methods Among the 300 patients diagnosed as breast papillary lesions by CNB,238 patients underwent breast tumor resection after CNB,and the diagnosis results of CNB and resection pathology were analyzed.Results 9 cases of breast disease diagnosed by surgical resection,accounting for 3.78%(9/238),were misdiagnosed by CNB,and no tumor tissue was found;CNB diagnosed 96 cases of intraductal papilloma(IP),accounting for 40.34%;74 cases of atypical intraductal papilloma(AIP),accounting for 31.09%;68 cases of papillary carcinoma(PC),accounting for 28.57%.CNB had misdiagnosis and missed diagnosis in the diagnosis of IP,AIP and PC.The coincidence rate of CNB and resection pathology in diagnosis of IP was 68.75%(66/96),that of AIP was 82.43%(61/74),and that of PC was 100.00%(68/68);in the diagnosis of IP,the grade of lesion was decreased in 25 cases,accounting for 26.04%(25/96);in the diagnosis of AIP,the grade of lesion was decreased in 6 cases,accounting for 8.11%(6/74).Conclusion When diagnosing breast papillary lesions,CNB can receive a more accurate diagnosis,but it underestimates the condition.It should be combined with resection pathological diagnosis to improve the accuracy of diagnosis.

关 键 词：乳腺 乳头状病变 穿刺 切除病理 对比分析 

分 类 号：R737.9[医药卫生—肿瘤]