积乳症与乳管内乳头状瘤(病)的相关性探讨

Correlation between the diseases of latex fill up and intraductal papillary epithelioma

目的探讨积乳症与乳管内乳头状瘤(病)的相关性。方法对2004年1月至2005年11月,经乳管镜诊断积乳症316例,应用乳管镜对溢乳以及合并乳头浆液性、血性溢液的病人进行检查,并选择部分病例进行乳管液雌孕激素受体检测及血清泌乳素测定。结果镜下诊断积乳症316例,积乳症合并乳管内乳头状瘤16例,合并多发性乳头状瘤2例,合并乳管内乳头状瘤病3例。手术21例,术后病理诊断乳管内乳头状瘤14例,乳头状瘤病3例,乳管炎伴炎性肉芽肿3例,乳腺腺病合并乳管扩张1例。行乳管脱落细胞雌孕激素受体检测93例,受体阳性79例;行泌乳素检测32例,21例垂体泌乳素高于正常范围,7例MRI检查脑垂体异常。结论乳管镜诊断积乳症直观、准确,可同时完成乳管内治疗,并能及时发现乳管内占位性病变。根据乳管液雌孕激素受体表达情况及血清泌乳素水平可推测积乳症与乳管内乳头状病变具有内在的相关性,有共同的发病基础。对积乳症须积极治疗,减少乳管内病变的发生率。

Objective To study the correlation between the diseases of latex fill up and intraductal papillary epithelioma. Methods From January 2004 to November 2005,316 patients with latex fill up and serosity, uprightness polyrrhea were examined by fiberoptic ductoscopy （FDS）. Estrogen receptor （ER）, progesterone receptor （PR） in galactophore douche and prolactin （PRL） in serum were detected in some patients. Results By FDS,316 patients were diagnosed as latex fill up. Among them, 16,2 and 3 patients were complicated with intracanalicular papilloma, multiple papillary epithelioma and papillomatosis. Twenty-one patients were performed operation. Among them, 14,3,3 and 1 patients were diagnosed as papillary epithelioma, papillomatosis ,galactophoritis complicated with phlegmasia granuloma and breast adenosis complicated with comedomastitis in pathology respectively. ER and PR of 93 patients were detected. Seventy-nine cases were positive. Serum PRL of 32 patients was detected. Among them, serum PRL of 21 patients was higher than the normal level. Seven of 21 patients were diagnosed as pituitary anomaly by MRI. Conclusion Using FDS to diagnosing the diseases of latex fill up is direct-viewing and accuratissime. FDS can also find and cure the intraductal occupying lesions. There are internal relationships between galactorrhea and papillomatosis based on the significant correlation between the ER, PR in galactophore douche and serum PRL. Diseases of latex fill up should be treated actively to decrease the incidence of intraductal lesions.