乳腺定位针在乳头溢液中的应用价值——附157例报告

Applied value on diagnosis and localization of breast-duct disease by breast duct endoscope and localization needle

为了评价乳管镜引导下乳腺定位针对乳管内病变的应用价值，以32例乳管造影患者为对照，应用德国Scholly纤维乳管镜检查了125乳头溢液患者，对其中65例乳管内占位者行乳管镜下病灶定位、切除，并与病理结果作对照。结果：造影组32例患者中12例检出乳管内占位，有26例接受手术治疗，均为腺叶切除。定位针组65例乳管内占位分别为乳腺癌2例（1．6％），乳管内乳头状瘤59例（47．2％），乳头状瘤病4例（2．4％），均予病灶定位，57例行部分腺叶切除，6例行腺叶切除，2例行改良根治术。定位针距病灶〈0.5cm 59例（90．77％）。0.5-2.0cm 6例（9.23％）。两组在腺体切除容量上差异有统计学意义，P〈0.01。初步研究结果提示，乳管镜下乳管内病灶的定位针定位，方便了乳管病灶的检诊，使乳房手术更精确、微创，并可辅助乳管镜诊断水平的提高。

This study was to evaluate breast duct endoscopy and breast localization needle in the diagnosis and therapy for breast duct disease. The images of breast duct of 125 patients （Group 1） with nipple discharges were ob-tained by breast duct endoscopy and computer assistant analysis system. Lesions were localized and inserted the nee-dles in 65 cases through the discharging nipple under the direction of breast duct endoscopy,and the results were com- pared with the outcomes of galactography of 32 patients（Group 2）. In group 1, early breast cancer were found in 2 ca-ses （5 % ）, papilloma in 59 cases （47.2 % ）. Papillomatosis in 4 cases （2.4 % ）. The distance between the needle and fo-cus is less than 0.5 cm in 59 cases（90.77%）, more than 0.5 cm but less than 2.0 cm in 6 cases（9.23%）. Lobectomy in 6 cases, partial lobectomy in 57 cases, radical modified mastectomy in 2 cases. In group 2, lobectomy was perform-ecd in 26 cases. There is significant difference in volumn of tissue-cut off between the Group 1 and 2, P〈0.001. The breast duct endoscopy and can detect and localize intraductal lesions of patients with nipple discharge, improve the ac-curacy of diagnosis and treatment, and diminute the excision of mammary gland volume.