纤维乳管镜诊断与乳管内隆起性病变病理分型的一致性  

Consistency of fiberoptic ductoscopy diagnosis and pathological classification of intraductal protuberant lesions

作　　者：白兰 BAI Lan(Beijing Daxing District Maternal and Child Health Hospital,Beijing 102600,China)

机构地区：[1]北京市大兴区妇幼保健院,北京102600

出　　处：《中国优生与遗传杂志》2023年第4期832-835,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的 探讨纤维乳管镜诊断与乳管内隆起性病变病理分型的一致性。方法 选取2020年1月至2022年8月于北京市大兴区妇幼保健院就诊的乳头溢液患者126例作为研究对象,纳入患者均行纤维乳管镜检查,以病理诊断为金标准,分析纤维乳管镜与病理诊断乳管内隆起性病变病理分型的一致性。结果 126例乳头溢液患者乳腺管切除病理结果显示,乳腺癌4例,乳管内乳头状瘤114例,乳腺增生8例。分析122例良性病变发现,术后病理检查与FDS检查乳管内乳头状瘤的检出率无显著差异(χ^(2)=1.458,P=0.108),且两种检查方式的Kappa值为0.877,Kappa值>0.75,两种检查方法在诊断乳管内乳头状瘤方面具有较高的一致性。进一步分析纤维乳管镜的诊断效能,结果显示,其诊断良恶性病变的敏感性为100%(8/8)、特异性为92.98%(106/114)、准确度为93.44%(114/122)、误诊率为7.02%(8/114)、漏诊率为0.00%(0/8)、阳性预测值为50.00%(8/16)、阴性预测值为100%(106/106)。与单发隆起性病变患者比较,多发隆起性病变患者双侧乳头溢液及多孔溢液比例明显增加(P<0.05),两组年龄及溢液颜色比较无显著差异(P>0.05)。对61例乳腺导管内囊性增生病例进行可疑乳管冲洗,治疗后33例治愈,15例好转,12例无效,治愈率为54.10%(33/61)。结论 纤维乳管镜在诊断乳管内乳头状瘤方面具有重要价值,可为临床诊断提供参考依据。Objective To explore the consistency of fiberoptic ductoscopy diagnosis and pathological classification of breast duct protuberant lesions.Methods 126 patients with nipple discharge who were hospitalized in Beijing Daxing District Maternal and Child Health Hospital from January 2020 to August 2022 were selected as the study subjects.All the patients were examined by fiberoptic ductoscopy.The consistency of pathological classification of breast duct protrusion lesions between fiberoptic ductoscopy and pathological diagnosis was analyzed based on the gold standard of pathological diagnosis.Results The pathological results of 126 patients with nipple discharge after segmental mastectomy showed that there were 4 cases of breast cancer,114 cases of intraductal papilloma,and 8 cases of breast hyperplasia.There was no significant difference in the detection rate of intraductal papilloma between pathological examination and FDS in 122 cases of benign lesions(χ^(2)=1.458,P=0.108),and the Kappa value of the two inspection methods is 0.877,and the Kappa value is>0.75.The two inspection methods have high consistency in the diagnosis of intraductal papilloma.Further analysis of the diagnostic efficacy of fiberoptic ductoscopy showed that the sensitivity,specificity,accuracy,misdiagnosis,missed diagnosis,positive predictive value,negative predictive value and negative predictive value of fiberoptic ductoscopy were 100%(8/8),92.98%(106/114),93.44%(114/122),7.02%(8/114),0.00%(0/8),50.00%(8/16)and 100%(106/106)respectively for benign and malignant lesions.Compared with patients with single protuberant lesions,the proportion of bilateral nipple discharge and porous discharge in patients with multiple protuberant lesions was significantly increased(P<0.05),and there was no significant difference in age and color of discharge between the two groups(P>0.05).61 cases of cystic hyperplasia in mammary duct were treated with douche of suspicious mammary duct.After treatment,33 cases were cured,15 cases were improved,12 cases were ineffe

关 键 词：隆起性病变 乳管 纤维乳管镜 诊断 一致性 

分 类 号：R655.8[医药卫生—外科学]