空心针活检与病理分级在乳腺非特殊浸润性癌一致性分析  

Consistency Analysis of Hollow Needle Biopsy and Pathological Grading in Non-specific Invasive Breast Cancer

作　　者：杨雄华 胡强 YANG Xionghua;HU Qiang(Department of Pathology,Wuyishan Municipal Hospital,Nanping Fujian 354300,China;Obstetrics and Gynecology Department,Wuyishan Municipal Hospital,Nanping Fujian 354300,China)

机构地区：[1]武夷山市立医院病理科,福建南平354300 [2]武夷山市立医院妇产科,福建南平354300

出　　处：《中国卫生标准管理》2021年第22期69-72,共4页China Health Standard Management

摘　　要：目的探讨空心针活检组织学分级与术后病理组织学分级在乳腺非特殊型浸润性癌一致性。方法选取2019年11月—2020年11月本院收治的乳腺非特殊型浸润性癌患者66例,均接受空心针活检组织学分级与术后病理组织学分级检查,对患者空心针穿刺肿瘤总长度进行计算,并对频率分布直方图予以绘制,比较手术治疗前后组织学分级差异。结果66例乳腺非特殊型浸润性癌患者中术后病理组织学分级显示Ⅰ级2例,Ⅱ级53例,Ⅲ级11例,66例患者手术治疗前后的组织学病理分级一致率为81.82%,差异有统计学意义(P<0.05)。Kappa检验结果显示:术前空心针活检组织学分级与术后病理组织学分级的一致性较高(Kappa=0.840,P<0.05),术前Ⅰ级与Ⅲ级空心针活检组织学分级与术后病理组织学分级的一致率明显低于Ⅱ级(Kappa=0.795、0.811、0.835,P<0.05);空心针穿刺肿瘤总长度为(32.20±10.36)mm,随着穿刺肿瘤长度的增加,术后病理组织学分级Ⅲ级的结构性评分符合率与核分裂评分符合率提高,但不同穿刺肿瘤长度范围一致率差异无统计学意义(P>0.05)。结论手术治疗前乳腺非特殊型浸润性癌的空心针活检组织学分级与术后病理组织学分级的一致率较高,通过将空心针穿刺肿瘤的总长度增加,可使一致率进一步提高。Objective To investigate the consistency of histopathological grading between hollow needle biopsy and postoperative histopathological grading in non-specific invasive breast carcinoma.Methods Sixty-six patients with non-specific invasive breast cancer from November 2019 to November 2020 in our hospital were selected.All patients underwent histological grading by hollow needle biopsy and postoperative histopathological grading.The total tumor length of patients with hollow needle puncture was calculated and the histogram of frequency distribution was drawn to compare the differences in histological grading before and after surgical treatment.Results Among 66 patients with nonspecific invasive breast cancer,postoperative histopathological grading showed gradeⅠin 2 cases,gradeⅡin 53 cases and gradeⅢin 11 cases.The consistency rate of histopathological grading before and after operation was 81.82%(P<0.05).Kappa test showed that the consistency between preoperative hollow needle biopsy histological grade and postoperative histopathological grade was high(Kappa=0.840,P<0.05),and the consistency between preoperative gradeⅠandⅢhollow needle biopsy histological grade and postoperative histopathological grade was significantly lower than gradeⅡ(Kappa=0.795,0.811,0.835,P<0.05).The total length of hollow needle puncture tumor was(32.20±10.36)mm.With the increase of puncture tumor length,the coincidence rate of structural score and mitotic score of postoperative histopathological gradeⅢincreased,but there was no significant difference in the coincidence rate of different puncture tumor length range(P>0.05).Conclusion There was a high consistency between the histological grade of the hollow needle biopsy and the postoperative histological grade of the non-specific invasive breast cancer before surgical treatment,and the consistency could be further improved by increasing the total length of the tumor with the hollow needle puncture.

关 键 词：乳腺 非特殊型浸润性癌 空心针活检 病理组织学分级 一致性 穿刺总长度 

分 类 号：R446[医药卫生—诊断学]