2 600例乳腺导管内乳头状肿瘤术中冷冻诊断与常规病理诊断结果对比分析  

Comparison of intraoperative frozen diagnosis and rountine pathological diagnosis of 2600 cases of intraductal papillary tumor of the breast

作　　者：杜红雁 雷莹 DU Hong-yan;LEI Ying(Department of Pathology,Northwest Women and Children’s Hospital,Xi’an 710061,China)

机构地区：[1]西北妇女儿童医院病理科,西安710061

出　　处：《临床与实验病理学杂志》2022年第7期806-810,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的统计2600例乳腺导管内乳头状肿瘤术中冷冻诊断和术后常规病理诊断的符合率,并分析诊断不一致的原因。方法收集2010~2020年西北妇女儿童医院存档的2600例术中冷冻诊断为乳腺导管内乳头状肿瘤标本,将术中冷冻诊断与术后常规病理诊断结果对比分析。结果2600例乳腺导管内乳头状肿瘤中,1964例术中冷冻诊断为良性,391例为非良性(不典型增生、原位癌和浸润癌),245例难以在术中明确病变性质。316例出现了术中冷冻诊断不足,57例出现了诊断过度。统计学分析发现,术中冷冻诊断不足与患者年龄(<45岁)、多发性导管内肿物、导管上皮平坦型不典型增生和ER弥漫强阳性有关(P<0.001);而诊断过度与冷冻细胞异型性、ER弥漫强阳性和p63肌上皮着色相关(P<0.001)。结论多数情况下,乳腺导管内乳头状肿瘤经术中冷冻诊断可明确良恶性,部分导管内乳头状肿瘤病变复杂,诊断不足和诊断过度者较多,必要时需结合术后常规病理诊断和免疫组化结果才能最终明确诊断。Purpose To calculate the compliance rate between intraoperative frozen diagnosis and postoperative rountine pathological diagnosis in 2600 cases of intraductal papillary tumor of breast,and to analyzed the reasons for inconsistent diagnosis.Methods 2600 cases of intraductal papillary tumor of breast diagnosed by intraoperative cryopreservation were collected from Northwest Women and Children’s Hospital from 2010 to 2020.The results from intraoperative frozen and postoperative rountine pathological diagnosis were analysis.Results Among 2600 cases of intraductal papillary neoplasms of breast,1964 cases were benign and 391 cases were non-benign(atypical hyperplasia,carcinoma in situ,and invasive carcinoma)at intraoperative frozen diagnosis,and 245 as non-specific lesions at frozen diagnosis..Intraoperative cryodiagnosis was underdiagnosed in 316 cases and overdiagnosed in 57 cases.Statistical analysis showed that the underdiagnosis of intraoperative diagnosis was associated with the patient's age(<45 years),multiple intraductal masses,flat ductal dysplasia,and diffuse positive ER(P<0.001).Overdiagnosis was associated with frozen cell atypia,diffuse strong positive ER,and p63 myoepithelial staining(P<0.001).Conclusion In most cases,intraductal papillary tumor of the breast can be diagnosed as benign and malignant at intraoperative frozen diagnosis.Some intraductal papillary tumors have comples lesions and are more often under-diagnosed and overdiagnosed.If necessary,the final diagnosis needs to be made in combination with postoperative routine pathological diagnosis and immunohistochemical results.

关 键 词：乳腺肿瘤 导管内乳头状瘤 术中冷冻诊断 常规病理诊断 

分 类 号：R737.9[医药卫生—肿瘤]