病理性乳头溢液单中心临床分析附168例报告  

Single center clinical analysis of pathological nipple discharge with 168 cases report

作　　者：高佳 姜吉询 王鑫[3] 吴婷 向江明 Gao Jia;Jiang Jixun;Wang Xin;Wu Ting;Xiang Jiangming(Department of Breast,Maternal and Child Health Hospital,Chongqing 401520,China;Department of Breast,Jiamusi Central Hospital,Jiamusi Heilongjiang Province 154000,China;Department of Breast,Jiamusi Maternal and Child Health Care Hospital,Jiamusi Heilongjiang Province 154000,China;Department of Breast,Maternal and Child Health Care and Family Planning Service Center,Chongqing 401220,China)

机构地区：[1]重庆市合川区妇幼保健院乳腺科,重庆401520 [2]佳木斯市中心医院乳腺科,黑龙江佳木斯154000 [3]佳木斯市妇幼保健院乳腺科,黑龙江佳木斯154000 [4]重庆市长寿区妇幼保健计划生育服务中心乳腺科,重庆401220

出　　处：《中华普外科手术学杂志（电子版）》2024年第3期323-326,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：重庆市妇幼科研培育项目(2021FY103)。

摘　　要：目的分析病理性乳头溢液(PND)患者的临床特征,探讨导管内癌变的危险因素。方法回顾性分析2020年1月至2023年8月168例PND患者的临床资料。根据溢液性质分为血性溢液组(n=71例)和非血性溢液组(n=97例);根据镜检后及术后病理结果分为良性病变组(n=155例)和恶性病变组(n=13例)。采用软件SPSS 19.0分析数据,计量资料采用(x±s)表示,行独立样本t检验;计数资料以[例(%)]表示,采用χ^(2)检验;多因素Logistic回归模型探究PND导管内癌变的独立危险因素。P<0.05为差异有统计学意义。结果PND患者多为单孔、单侧、血性溢液(浆液性溢液次之),术后病理证实恶性病变13例(7.7%)。伴乳腺肿块、镜下阳性指征、术后病理诊断及影像学BI-RADS分级在血性与非血性溢液组中差异有统计学意义(P<0.05)。年龄、血性溢液、乳管镜肿物表面充血、伴乳腺肿块、肿块大小、影像学BI-RADS分级及钼靶恶性钙化征象是PND导管内癌变的独立危险因素(P<0.05)。结论PND患者以单侧、单孔溢液为主,年龄>50岁、血性溢液、伴乳腺肿块且肿块>1 cm、乳管镜肿物表面充血、BI-RADS分级≥4类及有钼靶恶性钙化征象的患者发生导管内癌变的风险更高,应警惕早期出现恶性病变的可能。Objective To analyze the clinical features of patients with pathological papillary discharge(PND)and explore the risk factors of intraductal cancer.Methods The clinical data of 168 patients with PND from January 2020 to August 2023 were retrospectively analyzed.According to the nature of the discharge,the patients were divided into hemorrhagic discharge group(n=71 cases)and non-hemorrhagic discharge group(n=97 cases).According to the pathological results,the patients were divided into benign lesion group(n=155 cases)and malignant lesion group(n=13 cases).SPSS 19.0 software was used to analyze the data.Measurement data were represented by(x±s)and independent sample t test was performed.Counting data are represented by[cases(%)]andχ^(2)test is adopted.Multivariate Logistic regression model was used to investigate the independent risk factors for intraductal carcinoma of PND.P<0.05 was considered statistically significant.Results PND patients were mostly single-pore,unilateral,hemorrhagic discharge(serous discharge followed),and 13 cases(7.7%)were confirmed as malignant lesions.There were significant differences in the presence of breast mass,microscopic positive indication,postoperative pathological diagnosis and imaging BI-RADS classification between hemorrhagic and non-hemorrhagic discharge groups(P<0.05).Age,bleeding fluid discharge,surface hyperemia,breast mass,tumor size,imaging BI-RADS grade and molybdenum malignant calcification signs were independent risk factors for intraductal carcinoma of PND(P<0.05).Conclusion PND patients with unilateral,single-pore discharge,age>50 years,hemorrhagic discharge,breast mass>1 cm,hyperemia on the surface of the ductoperioscopic mass,BI-RADS grade≥4,and molybdenum target malignant calcification signs have a higher risk of intraductal cancer,and the possibility of early malignant lesions should be vigilant.

关 键 词：乳头溢液 导管内癌 临床特征 危险因素 

分 类 号：R737.9[医药卫生—肿瘤]