空芯针穿刺活检诊断乳腺乳头状病变的组织学低估及预测因素分析  

Underestimation and Predictive Factors on Core Needle Biopsy in Diagnosis of Breast Papillary Lesions

作　　者：魏建南 石剑 郑爱秋 WEI Jiannan;SHI Jian;ZHENG Aiqiu(Shenzhen Hospital,University of HongKong,Shenzhen 518048,China)

机构地区：[1]香港大学深圳医院,广东深圳518048

出　　处：《北华大学学报（自然科学版）》2021年第1期79-82,共4页Journal of Beihua University（Natural Science）

基　　金：广东省医学科研基金项目(B2016137).

摘　　要：目的分析应用空芯针穿刺活检(core needle biopsy,CNB)诊断乳腺乳头状病变的组织学低估及预测因素.方法收集经CNB诊断为乳腺乳头状病变且行手术切除的180例患者194个病灶,对比CNB与手术病理的结果,计算组织学低估率;并结合临床、超声及CNB病理特征,分析组织学低估的预测因素.结果180例患者共194个病灶纳入研究,组织学低估率为11.3%(22/194).单因素分析显示:组织学低估与不典型乳头状病变、肿块直径≥15 mm、有乳头溢液、导管扩张有关(P<0.05),与年龄≥40岁、月经状态、乳腺癌家族史、肿块是否可触及、肿块内部回声、形状、边界、血流信号和BI-RADS分级无关(均P>0.05).多因素Logistic回归分析显示:肿块直径≥15 mm、不典型乳头状病变是组织学低估的独立预测因素.结论经CNB诊断为乳腺乳头状病变的患者应行手术切除病变,其中肿块直径大于15 mm、不典型乳头状病变的患者组织学低估率高,应行扩大切除,以降低乳腺癌保乳手术切缘阳性率及再次手术率.Objective To investigate the underestimation and predictive factors of core needle biopsy(CNB)in diagnosis of breast papillary lesions.Method Breast papillary lesions diagnosed by CNB and received surgical resection were included.The pathological results of CNB and surgery,clinical and ultrasound data were retrospectively reviewed,the underestimation rate and predictive factors of underestimation were analyzed.Results A total of 180 patients with 194 lesions were included in this study,and the underestimation rate was 11.3%(22/194).Univariate analysis showed that the underestimation was related to atypical papillary lesion,tumor diameter≥15 mm,nipple discharge and dilated ducts(P<0.05),but not related to age≥40 years,menstrual status,family history of breast cancer,palpable mass,echo of the mass,shape,boundary,blood signal and BI-RADS grade(P>0.05).Multivariate Logistic regression analysis showed that tumor diameter≥15 mm and atypical papillary lesions were independent predictors of underestimation.Conclusion Surgical resection is recommended for papillary lesions diagnosed by CNB.If the tumor diameter is larger than 15 mm or CNB diagnosis of atypical papillary lesion,wide local excision should be performed to achieve a negative margin for breast cancer conserving surgery and reduce the rate of re-excision.

关 键 词：空芯针穿刺活检 乳头状病变 组织学低估 

分 类 号：R445.1[医药卫生—影像医学与核医学]