超声引导下乳腺小病灶78例的粗针穿刺活检

Ultrasound-guided core biopsy of impalpable breast nodule:clinical observation of 78 lesions

目的:分析超声引导下对触摸不清的乳腺病灶进行穿刺活检细胞学和病理学检查的诊断准确率。方法:70例女性中检出78个触摸不清的乳腺结节,在超声引导下用18g穿刺针穿刺活检。以术后病理诊断和随诊结果为标准,分析穿刺细胞学和病理组织学检查的诊断准确性。结果:穿刺细胞学诊断为良性者58个,可疑恶性者6个,有恶性细胞者14个,其中证实为恶性者分别为1个、2个和13个。敏感性为93.8%,特异性为91.9%,诊断准确率为92.3%;穿刺病理学诊断为良性病变者63个,恶性者15个,证实为恶性者分别为1个和15个,敏感性为93.8%,特异性为100%,诊断准确率为98.7%。2种方法的特异性一致,而敏感性和诊断准确率差异有统计学意义(P<0.05)。结论:对于不能触及的乳腺结节,超声引导下乳腺粗针穿刺的细胞学和病理学检查是可靠的诊断方法,且后者更有效。

Objective： To analyze the accuracy of cytological and histopathological diagnosis made by obtaining tissues through ultrasound-guided core biopsy in patients with impalpable breast lesions. Methods： Cytological and histopathological diagnoses were made by obtaining specimens through ultrasound-guided biopsy of 78 nodules and were compared with operative histopathological diagnoses or realistic resultS obtained through follow up to analyze their accuracy. Results： Cytological diagnosed 58 out of 78 nodules as benign lesions, 6 as intermediate, and 14 malignant, of which 1 benign, 2 intermediate and 13 malignant were confirmed as malignant respectively. Histopathological examination classified 63 nodules as benign lesions and 15 were malignant, of which 1 and 15 were proved to be malignant. This indicated that both cytological and histopathological diagnoses had equal sensitivity of 93.8%, the specificity and accuracy rate of them were 91.9% vs 100% （P〈0.05） and 92.3% vs 98.7% （P 〈 0. 05 ）, respectively. Conclusion ： As to impalpable nodules, both cytological and histopathological diagnosis by obtaining specimens through ultrasound-guided core biopsy are reliable diagnostic methods and the later of which is more effective.